Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 140733 | AK |
N | 225700000X | Massage Therapist | MT004477 | GA |
NPI | 1003142399 |
---|---|
Provider Name | Sharee Rowell |
First Address | Wasilla, AK 99687-1842 |
Second Address | Wasilla, AK 99654-6569 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2009 |
Last Update Date | 23/03/2019 |