Healthcare Provider Details

I. General information

NPI: 1750641460
Provider Name (Legal Business Name): HEATHER KULSHAN RASCH CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2012
Last Update Date: 05/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35477 KENAI SPUR HWY STE 216
SOLDOTNA AK
99669-7644
US

IV. Provider business mailing address

35477 KENAI SPUR HWY STE 216
SOLDOTNA AK
99669-7644
US

V. Phone/Fax

Practice location:
  • Phone: 907-252-4460
  • Fax: 907-260-4093
Mailing address:
  • Phone: 907-252-4460
  • Fax: 907-260-4093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number431644-00
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: