Individual
MR. JOSEPH MICKETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
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
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4348
OR
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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