Individual
DR. SANDRA LYNN VANLEUVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
1743 REDSTONE CENTER DR, SUITE 115, PARK CITY, UT 84098-7929
(435) 658-9200
(435) 658-9210
Mailing address
PO BOX 510708, SALT LAKE CITY, UT 84151-0708
(801) 213-3900
(801) 585-3655
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5426490-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D5371
—
UT
Enumeration date
06/07/2006
Last updated
11/23/2021
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