Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Justin Formanek, CMT

Individual provider Massage Therapist · NPI 1871340638

Mr. Justin Formanek, CMT is a Massage Therapist in Agoura Hills, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2024

Practice location Address checks out

28720 Roadside Dr Ste 177
Agoura Hills, CA 91301-4570
Phone: (805) 586-5934
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 89452 (CA)

Record details

NPI number1871340638
Entity typeIndividual (Type 1)
GenderMale
Credentials CMT
Sole proprietorYes
NPI enumeratedMay 1, 2024
Last updated in NPPESMay 1, 2024
Certification dateMay 1, 2024

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