Individual
LYDIA LEAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1250 E 3900 S STE 260, SLC, UT 84124-1371
(801) 265-2000
Mailing address
1250 E 3900 S STE 260, SLC, UT 84124-1371
(801) 265-2000
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
NONE
UT
Other
Enumeration date
04/13/2023
Last updated
07/22/2025
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