Individual
JASMINE LYNN NICKELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
104 KUTTER RD, FAIRBANKS, AK 99701-3169
(907) 799-4074
Mailing address
641 EBERHART ROAD, P.O. BOX 70516, FAIRBANKS, AK 99707
(907) 799-4074
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3680
AK
Other
Enumeration date
02/23/2010
Last updated
02/23/2010
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