Individual
JONATHAN LEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT,RYT-200, CH
Contact information
Practice address
20 MACOMBER AVE, N DARTMOUTH, MA 02747-3025
(508) 284-4752
Mailing address
20 MACOMBER AVE, N DARTMOUTH, MA 02747-3025
(508) 284-4752
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12812
MA
Other
Enumeration date
04/01/2015
Last updated
04/01/2015
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