Individual
MR. PETER JOHN LEICHTNAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 W IRONWOOD DR STE 309, COEUR D ALENE, ID 83814-2660
(509) 994-2105
Mailing address
1200 W IRONWOOD DR STE 309, COEUR D ALENE, ID 83814-2660
(509) 994-2105
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
ID
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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