Individual
BRUCE E LEAVITT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
324 10TH AVE, SUITE 124, SALT LAKE CITY, UT 84103-2853
(801) 408-3090
Mailing address
5502 FJORD CIR, TAYLORSVILLE, UT 84118-2357
(801) 966-7895
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
151778-1701
UT
Other
Enumeration date
02/08/2006
Last updated
07/08/2007
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