Individual
MATTHEW LILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
114 WOODLAND ST, HARTFORD, CT 06105-1208
(860) 714-8392
Mailing address
114 WOODLAND ST, HARTFORD, CT 06105-1208
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8724
CT
Other
Enumeration date
10/15/2021
Last updated
10/15/2021
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