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Mr. Andrei Vladimirovich Mitsourov, LMP
Massage Therapist in Milton Freewater, Oregon
NPI 1205104775

Andrei Vladimirovich Mitsourov is a Massage Therapist based in Milton Freewater, OR. Andrei Vladimirovich Mitsourov practices in Milton Freewater, OR and has the professional credentials of LMP. The NPI Number for Andrei Vladimirovich Mitsourov is 1205104775 and holds a License No. MA 60230518 (Oregon).

The current practice location address for Andrei Vladimirovich Mitsourov is 53387 W Crockett Rd, Milton Freewater, OR and can be reached out via phone at 509-540-1665.

Location: 53387 W Crockett Rd, Milton Freewater, OR, 97862-7941
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205104775
Provider Name
Andrei Vladimirovich Mitsourov
Credential
LMP
Provider Entity Type
Individual
Gender
Male
Address
53387 W Crockett Rd, Milton Freewater, OR, 97862-7941
Phone Number
509-540-1665
Fax Number
Provider Enumeration Date
12/12/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
53387 W Crockett Rd
City
Milton Freewater
State
Oregon
Zip
97862-7941
Phone Number
509-540-1665
Fax Number
person
Provider Business Mailing Address Details
Address
53387 W Crockett Rd
City
Milton Freewater
State
Oregon
Zip
97862-7941
Phone Number
509-540-1665
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
MA 60230518 (Washington)
Definition
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.
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