Individual
MARIAH CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 W MYSTERY AVE STE B, WASILLA, AK 99654-6335
(907) 521-8002
Mailing address
3954 N CORONADO ST, WASILLA, AK 99623-0922
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
143321
AK
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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