Individual
MRS. LEANN R CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
216 W. MIDLAND AVENUE, WOODLAND PARK, CO 80863
(719) 687-2599
(719) 687-3812
Mailing address
PO BOX 5796, WOODLAND PARK, CO 80866-5796
(719) 687-2599
(719) 687-3812
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9128
CO
Other
Enumeration date
05/07/2010
Last updated
05/07/2010
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