Provider Demographics
NPI:1063151348
Name:LEFFERT, MARY MARGARET WHELAN (DPT)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET WHELAN
Last Name:LEFFERT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:MARGARET
Other - Last Name:WHELAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 200880
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-0880
Mailing Address - Country:US
Mailing Address - Phone:678-837-7176
Mailing Address - Fax:404-777-1311
Practice Address - Street 1:1209 PASEO DEL NORTE STE 3
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2083
Practice Address - Country:US
Practice Address - Phone:719-569-5691
Practice Address - Fax:719-569-5689
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist