Organization
BRENT LEAVITT
Active
Other names
maximum security inc
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT R LEAVITT PA-C (OWNER)
(208) 760-9416
Entity
Organization
Contact information
Practice address
4928 PLEASANT VIEW DR, CHUBBUCK, ID 83202-1640
(208) 760-9416
Mailing address
4928 PLEASANT VIEW DR, CHUBBUCK, ID 83202-1640
(208) 760-9416
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
—
ID
Other
Enumeration date
09/25/2015
Last updated
09/25/2015
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