Individual
SHELLY WALTRIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11462 BUSINESS BLVD, EAGLE RIVER, AK 99577-7721
(907) 694-9224
Mailing address
11462 BUSINESS BLVD, EAGLE RIVER, AK 99577-7721
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
101432
AK
Other
Enumeration date
03/27/2017
Last updated
03/27/2017
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