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NPI 1790288033

NPI 1790288033 : RACHEL BARTH : JUNEAU, AK

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General NPI Number Information
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    NPI Number           |    1790288033
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    Entity Type          |    Individual 
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    Provider Name        |    RACHEL BARTH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/13/2018
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    Last Update Date     |    03/13/2018
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Provider Practice Location Address
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    Address Line         |    8391 AIRPORT BLVD 
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    City                 |    JUNEAU
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    State                |    AK
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    Zip                  |    99801-8065
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    Country              |    US
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    Telephone            |    907-790-4422
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    11909 GLACIER HWY APT 306 
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    City                 |    JUNEAU
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    State                |    AK
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    Zip                  |    99801-8790
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    Country              |    US
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    Telephone            |    
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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       |    115601
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    License Number State |    AK
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