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General NPI Number Information
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NPI Number | 1043130206
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Entity Type | Organization
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Legal Business Name | FIRE ISLAND WELLNESS, LLC - DBA FIRE ISLAND MASSAGE THERAPY
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Dates
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Enumeration Date | 07/17/2026
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Last Update Date | 07/17/2026
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Provider Practice Location Address
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Address Line | 505 W NORTHERN LIGHTS BLVD STE 104
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City | ANCHORAGE
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State | AK
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Zip | 99503-2552
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Country | US
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Telephone | 907-727-2326
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Fax |
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Provider Business Mailing Address
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Address Line | 7514 TIMBERWOLF CIR
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City | ANCHORAGE
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State | AK
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Zip | 99507-4813
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Country | US
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Telephone | 907-727-2326
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MARY KLEBS
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Credential | LMT
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Telephone | 907-727-2326
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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 |
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