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Individual

CLYDE LEIGH II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MT

Contact information

Practice address
890 3 MILE RD NW STE 1, GRAND RAPIDS, MI 49544-8216
(616) 460-9814
Mailing address
2060 ELMRIDGE DR NW, GRAND RAPIDS, MI 49504-2306
(616) 648-7707

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501003119
MI

Other

Enumeration date
01/12/2016
Last updated
01/12/2016
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