NPI 1184988156

Dmitriy Gervagin, LMT

Practitioner Massage Therapist Newton, MA

Practice location

Address: 44 High St, Newton, MA 02464-1232
Phone: (617) 828-4516

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 10680 (MA)

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Registry record

NPI: 1184988156
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Jun 2012
Record last updated: 25 Jun 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.