Individual
LESLEY D MORITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5965 FIRESTONE BLVD, FIRESTONE, CO 80504-6607
(720) 652-7055
(720) 652-7056
Mailing address
2101 MAIN ST, LONGMONT, CO 80501-1406
(720) 745-8030
(720) 745-8031
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0001446
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016912
KAISER-COMMERCIAL NUMBER
—
05
—
87386763
—
CO
Enumeration date
03/07/2007
Last updated
05/01/2020
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