Organization
GLACIER SALT CAVE AND SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL LYLE STEVENS (OWNER)
(907) 723-9491
Entity
Organization
Contact information
Practice address
917 GLACIER AVE STE 101, JUNEAU, AK 99801-1883
(907) 723-9491
Mailing address
917 GLACIER AVE STE 101, JUNEAU, AK 99801-1883
(907) 723-9491
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1016699
AK
Other
Enumeration date
12/06/2017
Last updated
06/16/2018
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