Individual provider · Type 1 NPI
Leslie A. Detienne
Massage Therapist · Portage, IN
NPI number
1760640759
Active
Practice location
5934 US Highway 6
Portage, IN 46368-4946
Mailing address
577 Sienna Ave
Portage, IN 46368-2560
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist Primary | 225700000X | None listed |
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.
Another provider at this address
About NPI 1760640759
Leslie A. Detienne's National Provider Identifier is 1760640759, issued on May 28, 2008. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portage, IN. The record was last updated on May 28, 2008.