Individual
MALLORY LEONARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4539 WOODGATE DR STE A, JANESVILLE, WI 53546-8205
(608) 289-4615
Mailing address
4539 WOODGATE DR STE A, JANESVILLE, WI 53546-8205
(608) 289-4615
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12619-146
WI
Other
Enumeration date
01/30/2018
Last updated
06/16/2018
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