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NPI Code Detail

MEDICARE: KETY MARIELYS RIVERA

MEDICARE: KETY MARIELYS RIVERA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist133077AK

General Provider Information

NPI Number : 1841811981
Entity Type Code : Individual
Provider Name (Legal Business Name) : KETY MARIELYS RIVERA
Provider Business Mailing Address
First Line : 13135 OLD GLENN HWY STE 100
Second Line :
City : EAGLE RIVER
State : AK
Zip : 99577-7584
Country : US
Telephone Number : 907-696-9090
Fax Number :
Provider Business Practice Location Address
First Line : 13135 OLD GLENN HWY STE 100
Second Line :
City : EAGLE RIVER
State : AK
Zip : 99577-7584
Country : US
Telephone Number : 907-696-9090
Fax Number : 907-696-9091
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2020
Last Update Date : 04/29/2020

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Directions to “ KETY MARIELYS RIVERA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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