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Individual

LAREITA LEAVITT BERKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
299 E 900 S, PROVO, UT 84606-6107
(801) 852-3779
Mailing address
1462 MOUNTAIN VIEW DR, SPANISH FORK, UT 84660-2702
(801) 310-6015

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
12/27/2019
Last updated
12/27/2019
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