Individual
TRACY LEITHAUSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
418 HARRIS ST, #313, JUNEAU, AK 99801-1083
(907) 830-0609
Mailing address
704 W 11TH ST, JUNEAU, AK 99801-1518
(907) 830-0609
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
101370
AK
Other
Enumeration date
09/22/2015
Last updated
11/19/2015
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