Individual
CHARLES LESLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
415 NE 3RD ST, MCMINNVILLE, OR 97128-6216
(503) 376-8329
Mailing address
415 NE 3RD ST, MCMINNVILLE, OR 97128-6216
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14555
OR
Other
Enumeration date
04/03/2013
Last updated
04/03/2013
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