Individual
EMILY MARGARET LYNGHOLM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3039 DAVIS RD, FAIRBANKS, AK 99709-5234
(907) 699-6557
Mailing address
PO BOX 35081, FT WAINWRIGHT, AK 99703-0081
(907) 699-6557
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
951770
DEPARTMENT OF COMMERCE, COMMUNITY, AND ECONOMIC DEVELOPMENT BUSINESS LICENSE
AK
Enumeration date
12/23/2010
Last updated
02/25/2012
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