Individual
LESLEY VANDERSARL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, ICNMT
Contact information
Practice address
127 E LAS ANIMAS ST, COLORADO SPRINGS, CO 80903-4137
(719) 306-6149
Mailing address
2550 E CACHE LA POUDRE ST APT 127, COLORADO SPRINGS, CO 80909-4978
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT0002657
CO
Other
Enumeration date
10/20/2021
Last updated
10/20/2021
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