Individual
MR. LORIN LEITHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
4095 E PONY EXPRESS PKWY, SUITE 1, EAGLE MOUNTAIN, UT 84005-5529
(801) 429-8037
(801) 753-7476
Mailing address
1055 N 500 W ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
312206-4405
UT
Other
Enumeration date
11/19/2013
Last updated
11/27/2023
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