Peter John Leichtnam
Clinic/Center in Coeur D Alene, ID. Individual provider (NPI-1).
NPI number1164072187
StatusActive
Last updated in NPPESSep 12, 2019
Details
- NPI
- 1164072187
- Entity type
- Individual (NPI-1)
- Name
- Mr. Peter John Leichtnam
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 12, 2019
- Last updated
- Sep 12, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | ID | Yes |
Practice location
1200 W Ironwood Dr Ste 309Coeur D Alene, ID 83814-2660
Phone 509-994-2105
Mailing address
1200 W Ironwood Dr Ste 309Coeur D Alene, ID 83814-2660
Phone 509-994-2105
Other practice locations
10905 E Montgomery Dr Ste 4
Spokane Valley, WA 99206-6606
Spokane Valley, WA 99206-6606
Phone 509-994-2105 · Fax 509-892-6924
1200 W Ironwood Dr Ste 309
Coeur D Alene, ID 83814-2660
Coeur D Alene, ID 83814-2660
Phone 509-994-2105
10905 E Montgomery Dr Ste 4
Spokane Valley, WA 99206-6606
Spokane Valley, WA 99206-6606
Phone 509-994-2105 · Fax 509-892-6924
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