Advanced Myotherapy

NPI #1366085250 in Ashland, Oregon

Provider Information

NPI Number: 1366085250
Entity Type: Organization
Organization Name: Advanced Myotherapy
Primary Specialty: Massage Therapist
Enumeration Date: Oct 23, 2019
Last Updated: Oct 23, 2019

Practice Location

Address: 279 LIBERTY ST
City: Ashland
State: Oregon
ZIP Code: 97520-2901
Phone: (541) 482-0413

Authorized Official

Name: MR. JOSEPH MICKETTI, LMT
Title: PRESIDENT
Phone: (541) 482-0413

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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