Individual
KATIE TALLENT MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
43335 KALIFORNSKY BEACH RD STE 16H, SOLDOTNA, AK 99669-8250
(907) 953-7874
Mailing address
53140 N SHORE CT, KENAI, AK 99611-9642
(907) 953-7874
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
191587
AK
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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