Individual
MRS. OLGA IVANILOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
12843 SAMOLINE AVE, DOWNEY, CA 90242-4134
(240) 383-6704
Mailing address
12843 SAMOLINE AVE, DOWNEY, CA 90242-4134
(240) 383-6704
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
63117
CA
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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