Individual
TIFFANY STACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
418 HARRIS ST STE 317, JUNEAU, AK 99801-1083
(907) 738-6369
Mailing address
PO BOX 211231, AUKE BAY, AK 99821-1231
(907) 738-6369
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
101927
AK
Other
Enumeration date
02/20/2016
Last updated
02/23/2016
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