Individual
DR. RICHARD WALLACE LEAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
16230 STATE HIGHWAY 53, SPRINGER, OK 73458-8248
(580) 768-5676
Mailing address
PO BOX 162, SPRINGER, OK 73458-0162
(580) 768-5676
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4319
OK
111N00000X
Chiropractor
A05914
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0188219
—
IA
Enumeration date
10/31/2006
Last updated
08/10/2022
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