Individual
MICHAEL LEBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T
Contact information
Practice address
5320 GOODING DR, AUSTIN, TX 78744-5401
(512) 589-3984
Mailing address
5320 GOODING DR, AUSTIN, TX 78744-5401
(512) 589-3984
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT125229
TX
Other
Enumeration date
06/26/2022
Last updated
06/26/2022
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