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Individual

BRENT LEEDLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
606 N 3RD AVE STE 201, SANDPOINT, ID 83864-1689
(208) 263-8597
(208) 265-0667
Mailing address
606 N 3RD AVE STE 201, SANDPOINT, ID 83864-1689
(208) 263-8597
(208) 265-0667

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
8474
MT
207X00000X
Orthopaedic Surgery Physician
Primary
M-10527
ID

Other

Enumeration date
09/09/2005
Last updated
01/27/2011
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