Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | 0887 | OR |
Y | 175F00000X | Naturopath | 3649277106 | UT |
NPI | 1043435738 |
---|---|
Provider Name | Dr. Donald T Leathers |
First Address | Moab, UT 84532 |
Second Address | Moab, UT 84532 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 08/07/2007 |