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Individual

LEANNA SUZETTE JOHNSON BLACKBURN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5424 W BROAD ST, COLUMBUS, OH 43228-1155
(614) 870-7288
(614) 870-7288
Mailing address
3100 LEWIS RD, COLUMBUS, OH 43207-3701
(614) 632-0529
(614) 350-8708

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33.017176
OH

Other

Enumeration date
11/30/2017
Last updated
01/14/2018
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