Individual
HEIDI WILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3039 DAVIS RD, FAIRBANKS, AK 99709-5234
(907) 452-3600
Mailing address
PO BOX 71886, FAIRBANKS, AK 99707-1886
(907) 322-2159
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
990606
AK
Other
Enumeration date
06/04/2013
Last updated
06/04/2013
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