Individual
JENNIFER ILENE DEGRAFFENRIED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
436 N MAIN ST, WASILLA, AK 99654-7018
(907) 376-8020
Mailing address
1788 E NEIL CIR APT 3, WASILLA, AK 99654-8241
(907) 717-5652
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
127543
AK
Other
Enumeration date
12/11/2017
Last updated
12/11/2017
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