Individual provider · Type 1 NPI

Andrei Vladimirovich Mitsourov, LMP

Massage Therapist · Milton Freewater, OR

NPI number 1205104775 Active

Practice location

53387 W Crockett Rd
Milton Freewater, OR 97862-7941

Call (509) 540-1665 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XMA 60230518 (WA)

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.

Other massage therapist providers in Milton Freewater

See all in Milton Freewater →

About NPI 1205104775

Andrei Vladimirovich Mitsourov, LMP's National Provider Identifier is 1205104775, issued on Dec 12, 2011. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Milton Freewater, OR. The record was last updated on Dec 12, 2011.