Individual
JADA HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
308 OLD STEESE HWY, FAIRBANKS, AK 99701-3126
(907) 451-7244
Mailing address
PO BOX 71920, FAIRBANKS, AK 99707-1920
(907) 378-3044
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
116665
AK
Other
Enumeration date
06/22/2017
Last updated
06/22/2017
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