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Individual

BRYANT VANLEEUWEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
777 HOSPITAL WAY STE 215, POCATELLO, ID 83201-5175
(208) 239-2770
Mailing address
777 HOSPITAL WAY STE 215, POCATELLO, ID 83201-5175
(208) 239-2770

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
8354
NE
208800000X
Urology Physician
Primary
M-17410
ID

Other

Enumeration date
06/26/2018
Last updated
06/16/2025
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