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General NPI Number Information
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NPI Number | 1457945081
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Entity Type | Organization
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Legal Business Name | AUTHENTIC YOU
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Dates
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Enumeration Date | 02/24/2021
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Last Update Date | 09/15/2021
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Provider Practice Location Address
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Address Line | 418 HARRIS ST
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City | JUNEAU
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State | AK
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Zip | 99801-1083
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Country | US
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Telephone | 719-337-4606
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Fax |
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Provider Business Mailing Address
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Address Line | 418 HARRIS ST
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City | JUNEAU
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State | AK
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Zip | 99801-1083
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Country | US
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Telephone | 907-531-5320
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Fax |
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Authorized Official
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Title or Position | LICENSED MASSAGE THERAPIST
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Name | BRITTANY OOMAN
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Credential | LMT
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Telephone | 719-337-4606
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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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