Individual
MICHELLE LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1701 N SEWARD MERIDIAN PKWY, WASILLA, AK 99654-6682
(907) 715-1540
Mailing address
4950 E BIRCH DR, WASILLA, AK 99654-4284
(907) 715-1540
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
101342
AK
Other
Enumeration date
06/10/2016
Last updated
06/10/2016
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