Individual
LESLIE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1104 N 4TH ST STE B, COEUR D ALENE, ID 83814-3217
(208) 292-4873
Mailing address
7430 N CALAMONTE LN, COEUR D ALENE, ID 83815-8549
(208) 719-1722
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3724
ID
Other
Enumeration date
08/02/2022
Last updated
08/02/2022
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