Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225700000X | Massage Therapist | ||
Y | 225700000X | Massage Therapist | 107656 | AK |
NPI | 1013433960 |
---|---|
Provider Name | Ms. Christine Susan Noel |
First Address | Anchorage, AK 99515-2048 |
Second Address | Anchorage, AK 99517-2678 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2017 |
Last Update Date | 22/08/2017 |