Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 101476 | AK |
NPI | 1003311325 |
---|---|
Provider Name | Helen Mary Meacham |
First Address | Anchorage, AK 99503-4146 |
Second Address | Anchorage, AK 99503-4146 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2018 |
Last Update Date | 28/03/2018 |