Individual
ANGELA IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
18540 WALRUS CIR, EAGLE RIVER, AK 99577-8615
(907) 696-8306
Mailing address
18540 WALRUS CIR, EAGLE RIVER, AK 99577-8615
(907) 696-8306
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
115496
AK
405300000X
Prevention Professional
115496
AK
Other
Enumeration date
01/26/2017
Last updated
04/05/2019
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