Individual
MICKIAH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
12641 OLD GLENN HWY STE 202, EAGLE RIVER, AK 99577-7040
(907) 214-1303
Mailing address
12641 OLD GLENN HWY STE 202, EAGLE RIVER, AK 99577-7040
(907) 214-1303
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
226809
AK
Other
Enumeration date
02/20/2024
Last updated
07/15/2024
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