Individual
LEVIATHAN BRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6484 N 2300 W, CEDAR CITY, UT 84721-7102
(435) 867-4876
(435) 867-4883
Mailing address
299 N 200 W, BOUNTIFUL, UT 84010-7043
(801) 815-3443
(801) 683-8962
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
01/26/2021
Last updated
01/26/2021
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