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Individual

ANTHONY PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
12812 OLD GLENN HWY STE C3, EAGLE RIVER, AK 99577-7002
(907) 376-8020
(907) 376-8017
Mailing address
12812 OLD GLENN HWY STE C3, EAGLE RIVER, AK 99577-7002
(907) 376-8020
(907) 376-8017

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
168575
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
168575
MASSAGE LICENSE
AK
Enumeration date
11/18/2020
Last updated
11/18/2020
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