Individual
LAKEN JEAN AMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7801 SCHOON ST STE B, ANCHORAGE, AK 99518-3039
(907) 344-0376
(907) 344-0708
Mailing address
6843 E 12TH AVE, ANCHORAGE, AK 99504-1831
(907) 631-9423
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
116666
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116666
PROFESSIONAL LICENSE
AK
Enumeration date
10/03/2017
Last updated
06/16/2018
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