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
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist Primary | 225700000X | MT.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.