Individual
DR. LEO MARTIN HATTRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
750 LANCERS CT W, MONUMENT, CO 80132-2806
(719) 659-5083
Mailing address
750 LANCERS CT W, MONUMENT, CO 80132-2806
(719) 659-5083
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
41947
CO
2083A0100X
Aerospace Medicine Physician
Primary
41947
CO
2083X0100X
Occupational Medicine Physician
41947
CO
Other
Enumeration date
11/04/2009
Last updated
11/04/2009
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