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1043962780
MIZUKO TAKAMOTO
MEDFORD, OR
NPI
1043962780
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 26563)
Enumeration Date
2022-01-24
Last Update Date
2023-09-14
Business Address
MIZUKO TAKAMOTO
3200 JUANIPERO WAY
MEDFORD, OR 97504-8580
Phone number: 541-816-4131
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Mailing Address
MIZUKO TAKAMOTO
PO BOX 12096
DES MOINES, IA 50312-9402
Phone number: 515-414-9339
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