Healthcare Provider Details

I. General information

NPI: 1154485092
Provider Name (Legal Business Name): RONATA EGERT CR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

813 D ST STE 101
ANCHORAGE AK
99501-3510
US

IV. Provider business mailing address

813 D ST STE 101
ANCHORAGE AK
99501-3510
US

V. Phone/Fax

Practice location:
  • Phone: 907-276-5525
  • Fax: 907-276-5005
Mailing address:
  • Phone: 907-276-5525
  • Fax: 907-276-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: