Individual
LESLIE N KEANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1042 SUTTON RD, ADRIAN, MI 49221-8344
(734) 363-8457
Mailing address
1042 SUTTON RD UNIT 2B, ADRIAN, MI 49221-8344
(734) 363-8457
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
L2274798
MI
225700000X
Massage Therapist
Primary
7501014525APP21
MI
Other
Enumeration date
07/27/2012
Last updated
04/12/2022
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