Individual
JESSICA COULLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
11806 GLACIER HWY STE 1B, JUNEAU, AK 99801-8644
(907) 020-9086
Mailing address
PO BOX 35643, JUNEAU, AK 99803-5643
(907) 209-0866
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
225700000X
Massage Therapist
Primary
149089
AK
Other
Enumeration date
03/10/2008
Last updated
02/27/2024
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