Doctor Name: | GINO AGOSTINELLI |
NPI Number: | 1346456753 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMP |
License Number: | MA00006069 |
Business Practice Address: | 12205 E 12th Ave Ste. 3 Spokane Valley, WA - 992065461 |
Business Phone Number: | 5098911400 |
Business Fax Number: | 5099270082 |
Mailing Address: | 12205 E 12th Ave, Ste. 3 SPOKANE VALLEY |
State: | WA |
Postal Code: | 992065461 |
Phone Number: | 5098911400 |
Fax Number: | 5099270082 |
NPI Enumeration Date: | 05/15/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA00006069 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy 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. |