Individual provider · Type 1 NPI
Stanislav Kononov, LMT
Massage Therapist · Glendale, WI
NPI number
1922748169
Active
Practice location
5215 N Ironwood Rd Ste 104
Glendale, WI 53217-4908
Mailing address
2222 E Belleview Pl Apt 104
Milwaukee, WI 53211-4005
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist Primary | 225700000X | 3048-146 (WI) |
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 Glendale
About NPI 1922748169
Stanislav Kononov, LMT's National Provider Identifier is 1922748169, issued on Mar 29, 2022. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Glendale, WI. The record was last updated on Mar 29, 2022.