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Individual

JEFFREY LEIBMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
625 POLE LINE RD W STE 2A, TWIN FALLS, ID 83301-4270
(208) 814-8600
(208) 814-8942
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1961270
ID
363A00000X
Physician Assistant

Other

Enumeration date
08/15/2022
Last updated
12/05/2024
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