Individual
STEPHANIE WIBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 N MAIN ST, WASILLA, AK 99654-7018
(907) 373-2022
Mailing address
HC 89 BOX 8193, TALKEETNA, AK 99676-9701
(415) 419-4272
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
102013
AK
Other
Enumeration date
03/23/2017
Last updated
03/23/2017
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