Individual
MELISSA MUELLER-SOUPHANAVONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7449 E 17TH AVE, ANCHORAGE, AK 99504-2708
(907) 244-2146
Mailing address
7449 E 17TH AVE, ANCHORAGE, AK 99504-2708
(907) 244-2146
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
152646
AK
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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