Individual
LESLIE M SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3005 DIXIE HWY STE 20, EDGEWOOD, KY 41017-2380
(407) 212-5814
Mailing address
3005 DIXIE HWY STE 20, EDGEWOOD, KY 41017-2380
(407) 212-5814
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
107614
KY
Other
Enumeration date
02/08/2020
Last updated
07/24/2024
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