Individual
EMILY HAZE WIKLE BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
308 OLD STEESE HWY, FAIRBANKS, AK 99701-3126
(907) 451-7246
(907) 451-7244
Mailing address
3415 OUR ST, NORTH POLE, AK 99705-6359
(907) 863-1010
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
101359
AK
Other
Enumeration date
06/18/2017
Last updated
06/18/2017
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