Breelyn Jan Van Leeuwen, PA-C, MSPA

NPI #1043640071 in Provo, Utah

Provider Information

NPI Number: 1043640071
Entity Type: Individual
Name: Breelyn Jan Van Leeuwen, PA-C, MSPA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C, MSPA
Enumeration Date: Nov 12, 2013
Last Updated: Jan 9, 2014

Practice Location

Address: 1055 N 500 W STE 211
City: Provo
State: Utah
ZIP Code: 84604-3305
Phone: (801) 357-7327

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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