Individual
LESLIE ANN SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
208 PAULINE DR STE B, BEREA, KY 40403-9117
(859) 358-7251
Mailing address
208 PAULINE DR STE B, BEREA, KY 40403-9117
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
165790
KY
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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