Individual
MRS. LESLIE ANN MELLOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
33220 NE MERSHON RD, CORBETT, OR 97019
(503) 695-3492
Mailing address
33220 NE MERSHON RD, CORBETT, OR 97019
(503) 695-3492
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2944
OR
Other
Enumeration date
07/07/2008
Last updated
07/07/2008
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