Individual
RENAE JEAN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3498 SOUTH LAKEVIEW LOOP, BIG LAKE, AK 99652
(907) 892-1628
(907) 892-1629
Mailing address
PO BOX 521833, BIG LAKE, AK 99652-1833
(907) 892-1628
(907) 892-1629
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
107490
AK
Other
Enumeration date
05/18/2016
Last updated
09/02/2016
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