Individual
MS. LAURIE ANN LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT, CLT
Contact information
Practice address
1765 45TH AVE, VERO BEACH, FL 32966-2317
(772) 342-8123
Mailing address
1765 45TH AVE, VERO BEACH, FL 32966-2317
(772) 342-8123
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA56539
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA56539
FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
06/23/2021
Last updated
06/23/2021
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