NPI 1336603521

Michael Mugnolo, CMTLMT

Practitioner Massage Therapist Vienna, VA

Practice location

Address: 307 Maple Ave W STE L, Vienna, VA 22180-4307
Phone: (703) 672-1613

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 0019014199 (VA)

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Registry record

NPI: 1336603521
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Jan 2019
Record last updated: 11 Jun 2019

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.