Healthcare Provider Details

I. General information

NPI: 1922563592
Provider Name (Legal Business Name): VINCENT MILOSEVICH LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2019
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 N NARBERTH AVE
NARBERTH PA
19072-2347
US

IV. Provider business mailing address

31 N NARBERTH AVE
NARBERTH PA
19072-2347
US

V. Phone/Fax

Practice location:
  • Phone: 215-821-9413
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number9006
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMSG016713
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: