Provider Demographics
NPI:1518347442
Name:MASSAGE BY DENISE LESLIE INC.
Entity Type:Organization
Organization Name:MASSAGE BY DENISE LESLIE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:LESLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-295-7040
Mailing Address - Street 1:8737 DUNWOODY PLACE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350
Mailing Address - Country:US
Mailing Address - Phone:404-295-7040
Mailing Address - Fax:
Practice Address - Street 1:8737 DUNWOODY PL
Practice Address - Street 2:SUITE 4
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-2985
Practice Address - Country:US
Practice Address - Phone:404-295-7040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA08771172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172M00000XOther Service ProvidersMechanotherapistGroup - Multi-Specialty