MEDICARE: DUANA LINN KRAUSE 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
1	225700000X	Massage Therapist
2	225700000X	Massage Therapist	101811	AK

General Provider Information

NPI Number	:	1790291698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUANA LINN KRAUSE LMT

Provider Business Mailing Address
First Line	:	1773 COLLEGE RD
Second Line	:
City	:	FAIRBANKS
State	:	AK
Zip	:	99709-4176
Country	:	US
Telephone Number	:	907-457-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1773 COLLEGE RD
Second Line	:
City	:	FAIRBANKS
State	:	AK
Zip	:	99709-4176
Country	:	US
Telephone Number	:	907-457-5100
Fax Number	:

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

Provider Enumeration Date	:	12/14/2017
Last Update Date	:	12/14/2017

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Directions to “ DUANA LINN KRAUSE LMT” Practice Location

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