Individual
LESLIE LYNN DORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
915 55TH ST, SUITE 101, WESTERN SPRINGS, IL 60558-2218
(708) 415-6896
Mailing address
519 55TH STREET, SUITE 101, WESTERN SPIRNGS, IL 60558-2268
(708) 415-6896
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227006115
IL
Other
Enumeration date
12/12/2011
Last updated
12/12/2011
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