Eagle River Therapeutic Massage LLC

NPI #1689969966 in Eagle River, Alaska

Provider Information

NPI Number: 1689969966
Entity Type: Organization
Organization Name: Eagle River Therapeutic Massage LLC
Primary Specialty: Massage Therapist
Enumeration Date: Jun 14, 2011
Last Updated: Jun 14, 2011

Practice Location

Address: 10421 VFW RD
Address 2: SUITE 101
City: Eagle River
State: Alaska
ZIP Code: 99577-8032
Phone: (907) 351-7191

Authorized Official

Name: MRS. JEANETTE STACK, LMP, NCTMB
Title: OWNER/MEMBER
Phone: (907) 351-7191

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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