Healthcare Provider Details

I. General information

NPI: 1215511985
Provider Name (Legal Business Name): ALANIS BERGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 05/10/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 W NORTHERN LIGHTS BLVD SUITE C
ANCHORAGE AK
99503
US

IV. Provider business mailing address

1350 W NORTHERN LIGHTS BLVD SUITE C
ANCHORAGE AK
99503
US

V. Phone/Fax

Practice location:
  • Phone: 907-334-8020
  • Fax:
Mailing address:
  • Phone: 907-334-8020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number169769
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: