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General NPI Number Information
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NPI Number | 1003295155
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Entity Type | Individual
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Provider Name | SUZANNE WEBB MT
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Gender | Female
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Dates
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Enumeration Date | 05/22/2015
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Last Update Date | 12/22/2023
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Provider Practice Location Address
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Address Line | 15 NORTH 12TH STREET SUITE 222
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City | PETERSBURG
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State | AK
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Zip | 99833-1398
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Country | US
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Telephone | 501-502-0464
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1398
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City | PETERSBURG
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State | AK
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Zip | 99833-1398
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Country | US
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Telephone | 501-502-0464
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State | AK
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