Organization
LEAVITT WOMENS HEALTHCARE CORP,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN LEAVITT DO (OWNER)
(208) 529-4942
Entity
Organization
Contact information
Practice address
1550 ELK CREEK DR, IDAHO FALLS, ID 83404-8322
(208) 529-5942
Mailing address
1550 ELK CREEK DR, IDAHO FALLS, ID 83404-8322
(208) 529-5942
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
O0365
ID
Other
Enumeration date
02/14/2008
Last updated
10/01/2014
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