Individual
PHILLIP LEAVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4718 23RD AVE, MISSOULA, MT 59803-1163
(406) 251-6410
Mailing address
100 SAGE LN, HAMILTON, MT 59840-3630
(406) 375-2342
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1966
MT
225200000X
Physical Therapy Assistant
7347A
AZ
Other
Enumeration date
04/22/2007
Last updated
07/08/2007
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