Individual
MS. SHOSHANNA WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
620 MAIN STREET, PORT LIONS, AK 99550
(907) 441-4042
Mailing address
PO BOX 51, PORT LIONS, AK 99550-0051
(907) 441-4042
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
101664
AK
Other
Enumeration date
06/24/2016
Last updated
02/02/2023
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