GLENN RALPH LEAVITT

IDAHO FALLS, ID
NPI1386644318
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207V00000X Obstetrics & Gynecology
(Licence: ID  O-0365)
Enumeration Date2005-08-01
Last Update Date2012-03-01
Business Address
Dr. GLENN RALPH LEAVITT DO
1550 ELK CRK
IDAHO FALLS, ID 83404-8322
Phone number: 208-529-5942
Mailing Address
Dr. GLENN RALPH LEAVITT DO
1550 ELK CRK
IDAHO FALLS, ID 83404-8322
Phone number: 208-535-4580
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