Individual
OLIVIA NICOLE BOUNTHANOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4110 BULLARD AVE UNIT B, JBER, AK 99506-1406
(907) 351-8383
(907) 351-8383
Mailing address
4110 BULLARD AVE UNIT B, JBER, AK 99506-1406
(907) 351-8383
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
118100
AK
Other
Enumeration date
11/15/2017
Last updated
11/15/2017
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