Individual
SHANNON BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3161 E PALMER WASILLA HWY STE 1A, WASILLA, AK 99654-7271
(360) 907-1654
Mailing address
PO BOX 670202, CHUGIAK, AK 99567-0202
(360) 907-1654
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
169822
AK
Other
Enumeration date
01/28/2021
Last updated
08/20/2024
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