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1043640071
BREELYN JAN VAN LEEUWEN
PROVO, UT
NPI
1043640071
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: UT 8808600-1206)
Enumeration Date
2013-11-12
Last Update Date
2014-01-09
Business Address
-- BREELYN JAN VAN LEEUWEN PA-C, MSPA
1055 N 500 W STE 211
PROVO, UT 84604-3305
Phone number: 801-357-7327
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Mailing Address
-- BREELYN JAN VAN LEEUWEN PA-C, MSPA
1055 N 500 W
PROVO, UT 84604-3305
Phone number: 801-812-4673
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