Individual
LEOPOLDO MIRANDA DELATORRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
5261 ADAMS AVE PKWY, WASHINGTON TERRACE, UT 84405-6748
(801) 475-7733
Mailing address
1702 E 5600 S, SOUTH OGDEN, UT 84403-4384
(801) 689-2546
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9730693-4701
UT
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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