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Individual

MIC LEESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
7595 W 66TH AVE, ARVADA, CO 80003-3909
(303) 381-0188
Mailing address
933 GRAYS PEAK DR, SUPERIOR, CO 80027-6092

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0026226
CO

Other

Enumeration date
04/15/2024
Last updated
04/15/2024
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