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General NPI Number Information
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NPI Number | 1316625171
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Entity Type | Individual
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Provider Name | LAUREL ALEXANDREA MAY
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Gender | Female
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Dates
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Enumeration Date | 07/10/2023
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 10421 VFW RD
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City | EAGLE RIVER
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State | AK
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Zip | 99577-8075
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Country | US
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Telephone | 907-694-1285
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Fax |
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Provider Business Mailing Address
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Address Line | 12110 BUSINESS BLVD STE A6 PMB 306
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City | EAGLE RIVER
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State | AK
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Zip | 99577
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Country | US
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Telephone | 706-691-9354
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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 | 211289
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License Number State | AK
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