Individual
LESLIE TREVIZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6200 W 9TH ST UNIT 4B, GREELEY, CO 80634-4462
(720) 291-2892
Mailing address
PO BOX 873, KERSEY, CO 80644-0873
(720) 291-2892
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0016919
CO
Other
Enumeration date
11/30/2021
Last updated
11/30/2021
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