Individual
MARK A. LEAVITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T., CFP
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1050
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011457
BCBS
ME
05
—
127700000
—
ME
01
—
2111062
AETNA
ME
01
—
415407
TUFTS
ME
01
—
M21444
CIGNA
ME
Enumeration date
11/16/2006
Last updated
03/18/2016
Update your record
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