Individual
MR. LELAND GREER WHITEHURST II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, NCTMB
Contact information
Practice address
1404 33RD ST S, #G, FARGO, ND 58103-3482
(701) 200-2712
Mailing address
1404 33RD ST S, #G, FARGO, ND 58103-3482
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1293
ND
Other
Enumeration date
03/29/2013
Last updated
03/29/2013
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