Individual
LONNIE URBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2405 S KNIK GOOSE BAY RD, WASILLA, AK 99654
(907) 978-5869
Mailing address
6220 S HALLIE DR, WASILLA, AK 99623-8852
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
AK
225700000X
Massage Therapist
—
—
Other
Enumeration date
07/22/2019
Last updated
08/31/2021
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