Individual provider · Type 1 NPI

Leslie Icaro, MT

Massage Therapist · Wheat Ridge, CO

NPI number 1639845183 Active

Practice location

4380 Harlan St Ste 202
Wheat Ridge, CO 80033-5137

Mailing address

13150 Wide Acres Rd
Golden, CO 80401-4143

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XMT.0006164 (CO)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1639845183

Leslie Icaro, MT's National Provider Identifier is 1639845183, issued on Aug 16, 2021. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Wheat Ridge, CO. The record was last updated on Aug 16, 2021.