Organization
ADVANCED MYOTHERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH MICKETTI LMT (PRESIDENT)
(541) 482-0413
Entity
Organization
Contact information
Practice address
279 LIBERTY ST, ASHLAND, OR 97520-2901
(541) 482-0413
Mailing address
1467 SISKIYOU BLVD # 53, ASHLAND, OR 97520-2336
(541) 482-0413
(541) 482-0413
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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