Individual
MR. LEAVITT WOODLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
560 W 465 N STE 603, PROVIDENCE, UT 84332-8006
(435) 557-4292
(502) 490-4677
Mailing address
560 W 465 N STE 603, PROVIDENCE, UT 84332-8006
(435) 557-4292
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/04/2025
Last updated
12/23/2025
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