Provider Demographics
NPI:1255693453
Name:LECHTENBERG, GARRET THOMAS (MD)
Entity type:Individual
Prefix:
First Name:GARRET
Middle Name:THOMAS
Last Name:LECHTENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1760 E KEN PRATT BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-5311
Mailing Address - Country:US
Mailing Address - Phone:720-718-3930
Mailing Address - Fax:720-718-0939
Practice Address - Street 1:1760 E KEN PRATT BLVD STE 205
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80504-5311
Practice Address - Country:US
Practice Address - Phone:720-718-3930
Practice Address - Fax:720-718-0939
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI67072208600000X
MN62014208600000X
CODR.0076300208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery