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Brent Leavitt
NPI 1740650548 · on the registry since 2015 · sole proprietor
Practice
- Address
- 4928 Pleasant View Dr
Chubbuck, ID 83202 - Phone
- (208) 760-9416
- Organisation at this address
- Brent Leavitt
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2015-10-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho