Individual
LESLIE ICARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
4380 HARLAN ST STE 202, WHEAT RIDGE, CO 80033-5137
(303) 472-0193
Mailing address
13150 WIDE ACRES RD, GOLDEN, CO 80401-4143
(303) 472-0193
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0006164
CO
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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