Individual
LAURA ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8301 BRIARWOOD ST, ANCHORAGE, AK 99518-3333
(907) 953-8055
Mailing address
1931 WASHINGTON AVE, ANCHORAGE, AK 99515-2508
(907) 953-8055
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
164846
AK
225700000X
Massage Therapist
Primary
16506
HI
Other
Enumeration date
01/08/2021
Last updated
01/08/2021
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