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General NPI Number Information
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NPI Number | 1790601920
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Entity Type | Organization
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Legal Business Name | WILD LIGHT MASSAGE & WELLNESS LLC
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Dates
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Enumeration Date | 06/24/2026
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Last Update Date | 06/24/2026
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Provider Practice Location Address
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Address Line | 868 TONGLEN RD
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City | DENALI PARK
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State | AK
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Zip | 99755-0247
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Country | US
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Telephone | 207-812-0246
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 454
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City | DENALI NATIONAL PARK
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State | AK
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Zip | 99755-0454
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Country | US
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Telephone | 207-812-0246
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATE ORLOFSKY
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Credential | LMT
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Telephone | 207-812-0246
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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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