| Mr Stanislav Kononov, LMT | |
|
5215 N Ironwood Rd Ste 104, Glendale, WI 53217-4908 | |
| (414) 334-1023 | |
| Not Available |
| Full Name | Mr Stanislav Kononov |
|---|---|
| Gender | Male |
| Speciality | Massage Therapist |
| Location | 5215 N Ironwood Rd Ste 104, Glendale, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922748169 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225700000X | Massage Therapist | 3048-146 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Stanislav Kononov, LMT 2222 E Belleview Pl Apt 104, Milwaukee, WI 53211-4005 Ph: (414) 334-1023 | Mr Stanislav Kononov, LMT 5215 N Ironwood Rd Ste 104, Glendale, WI 53217-4908 Ph: (414) 334-1023 |
Larissa Lynn Perry, LMT Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 5261 N Port Washington Rd, Glendale, WI 53217 Phone: 414-332-6001 Fax: 414-332-3712 | |
Casandra Stieber, LMT Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 5261 N Port Washington Rd, Glendale, WI 53217 Phone: 414-332-6001 Fax: 414-332-3712 |