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Individual

LESLI MCQUISTON LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
1106 N E ST, LAKE WORTH, FL 33460-2063
(561) 319-1814
Mailing address
1106 N E ST, LAKE WORTH, FL 33460-2063
(561) 319-1814

Taxonomy

Speciality
Code
Description
License number
State
174H00000X
Health Educator
513873
FL
225700000X
Massage Therapist
Primary
MA 44605
FL

Other

Enumeration date
03/01/2012
Last updated
03/01/2012
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