Individual
MS. LEAH ILENE DVORKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, ATC, OT-SC
Contact information
Practice address
181 W MEADOW DR, VAIL, CO 81657-5242
(970) 476-1100
Mailing address
1520 AVENUE PL, #1403, ATLANTA, GA 30329-4015
(970) 376-8041
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
09-0838
CO
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
08/04/2010
Last updated
01/29/2015
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