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Individual

RAVEN LYNN ROGGENBUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8130 OLD SEWARD HWY STE 103, ANCHORAGE, AK 99518-3349
(907) 522-7466
Mailing address
3810 W 79TH AVE APT 1, ANCHORAGE, AK 99502-4321
(907) 764-4164

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
156537
AK
225700000X
Massage Therapist
156937
AK

Other

Enumeration date
09/30/2021
Last updated
09/30/2021
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