Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 101419 | AK |
NPI | 1003320060 |
---|---|
Provider Name | Christine G. Morin |
First Address | Kenai, AK 99611 |
Second Address | Kenai, AK 99611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2017 |
Last Update Date | 28/11/2017 |