Individual
ALLEN LEAVITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
451 4TH ST, KETCHUM, ID 83340
(208) 726-2596
(208) 726-8268
Mailing address
PO BOX 9200, KETCHUM, ID 83340-7143
(208) 726-2596
(208) 726-8268
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6867
ID
Other
Enumeration date
11/08/2013
Last updated
11/08/2013
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