Individual
BRENDAN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1830 E PARKS HWY STE A137, WASILLA, AK 99654-7378
(907) 232-7751
Mailing address
1830 E PARKS HWY STE A137, WASILLA, AK 99654-7378
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
186472
AK
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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