Individual
DANIIL I KISELEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1314 S 16TH ST, PHILADELPHIA, PA 19146-4709
(484) 869-1261
Mailing address
1314 S 16TH ST, PHILADELPHIA, PA 19146-4709
(484) 869-1261
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG013562
PA
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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