Provider Demographics
NPI:1962635946
Name:OHMAN, LEIF
Entity type:Individual
Prefix:MR
First Name:LEIF
Middle Name:
Last Name:OHMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-2303
Mailing Address - Country:US
Mailing Address - Phone:307-754-5915
Mailing Address - Fax:307-754-4600
Practice Address - Street 1:349 W 3RD ST
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:WY
Practice Address - Zip Code:82435-2303
Practice Address - Country:US
Practice Address - Phone:307-754-5915
Practice Address - Fax:307-754-4600
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator