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Individual

LEVI C LEONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2401 S 31ST ST, MENTAL HEALTH CLINIC, TEMPLE, TX 76508-0001
(254) 724-2585
Mailing address
235 E STATE ST, SAINT CROIX FALLS, WI 54024-4117
(715) 483-3221
(715) 483-0507

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
54491
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1740449180
MN
05
1740449180
WI
Enumeration date
06/02/2008
Last updated
08/10/2010
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