Individual
BETH A FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
311 SAINT MORITZ, GIRDWOOD, AK 99587
(269) 718-9736
Mailing address
PO BOX 895, GIRDWOOD, AK 99587-0895
(269) 718-9736
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
110936
AK
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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