Individual
JESSICA ANN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3161 E PALMER WASILLA HWY STE 1, WASILLA, AK 99654-7271
(907) 357-1818
Mailing address
13062 ROSSER DR, EAGLE RIVER, AK 99577-6725
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
12/13/2017
Last updated
12/13/2017
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