Provider Demographics
NPI:1851635833
Name:NAVAR, LEILANI (LAC)
Entity Type:Individual
Prefix:
First Name:LEILANI
Middle Name:
Last Name:NAVAR
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1497
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:UT
Mailing Address - Zip Code:84716-1497
Mailing Address - Country:US
Mailing Address - Phone:435-335-7700
Mailing Address - Fax:
Practice Address - Street 1:842 W HWY 12
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:UT
Practice Address - Zip Code:84716
Practice Address - Country:US
Practice Address - Phone:435-335-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9582448-1201171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist