Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 3093 | CO |
NPI | 1013235530 |
---|---|
Provider Name | Mrs. Donna J Leigh |
First Address | Woodland Park, CO 80866-5796 |
Second Address | Woodland Park, CO 80863 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2010 |
Last Update Date | 07/05/2010 |