MEDICARE: DEBORAH JEANNE FORSLIN MASSAGE THERAPIST

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
1	172M00000X	Mechanotherapist	932312	AK

General Provider Information

NPI Number	:	1134456148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH JEANNE FORSLIN MASSAGE THERAPIST

Provider Business Mailing Address
First Line	:	12805 E ALLISON CT
Second Line	:
City	:	PALMER
State	:	AK
Zip	:	99645-9024
Country	:	US
Telephone Number	:	907-841-2957
Fax Number	:

Provider Business Practice Location Address
First Line	:	472 N MAIN ST
Second Line	:	SUITE B
City	:	WASILLA
State	:	AK
Zip	:	99654-7018
Country	:	US
Telephone Number	:	907-841-2957
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2009
Last Update Date	:	11/11/2009

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Directions to “ DEBORAH JEANNE FORSLIN MASSAGE THERAPIST” Practice Location

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