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General NPI Number Information
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NPI Number | 1700770146
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Entity Type | Individual
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Provider Name | LESLIE MCCLELLAN LMT
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Gender | Female
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 1664 S DIXIE DR STE L104
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City | SAINT GEORGE
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State | UT
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Zip | 84770-7331
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Country | US
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Telephone | 435-668-8977
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Fax | 435-222-2118
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Provider Business Mailing Address
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Address Line | 1664 S DIXIE DR STE L104
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City | SAINT GEORGE
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State | UT
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Zip | 84770-7331
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Country | US
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Telephone | 435-668-8977
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Fax | 435-222-2118
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 13128309-4701
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License Number State | UT
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