NPI 1962804120

Leanne M Kovick, CFM

Practitioner Mastectomy Fitter Caldwell, ID

Practice location

Address: 2006 Blaine St, Caldwell, ID 83605-4343
Phone: (208) 985-5404
Fax: (208) 402-5959

Registered specialties

Mastectomy Fitter Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224900000X Licence CFM02746 (ID)

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Registry record

NPI: 1962804120
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 Sep 2014
Record last updated: 7 Dec 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.