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NPI Code Detail

MEDICARE: HEATHER ELIZABETH TUCKER LMT

MEDICARE: HEATHER ELIZABETH TUCKER LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist101778AK

General Provider Information

NPI Number : 1023530003
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER ELIZABETH TUCKER LMT
Provider Business Mailing Address
First Line : 1130 W DIMOND BLVD STE D
Second Line :
City : ANCHORAGE
State : AK
Zip : 99515-1511
Country : US
Telephone Number : 908-868-1517
Fax Number : 907-868-9053
Provider Business Practice Location Address
First Line : 1130 W DIMOND BLVD STE D
Second Line :
City : ANCHORAGE
State : AK
Zip : 99515-1511
Country : US
Telephone Number : 908-868-1517
Fax Number : 907-868-9053
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2017
Last Update Date : 07/21/2022

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Directions to “ HEATHER ELIZABETH TUCKER LMT” Practice Location

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