Individual
ERICA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3535 COLLEGE RD, FAIRBANKS, AK 99709-3724
(907) 590-7258
Mailing address
1289 LOWBUSH LN, FAIRBANKS, AK 99709-6039
(907) 978-2896
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
176383
AK
Other
Enumeration date
06/15/2021
Last updated
08/28/2023
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