Provider Demographics
NPI:1447798996
Name:ALASKA MASSAGE STUDIO LLC
Entity type:Organization
Organization Name:ALASKA MASSAGE STUDIO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:DROLLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:509-426-0131
Mailing Address - Street 1:1212 W MYSTERY AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-6335
Mailing Address - Country:US
Mailing Address - Phone:907-521-8002
Mailing Address - Fax:509-834-7696
Practice Address - Street 1:1212 W MYSTERY AVE
Practice Address - Street 2:SUITE B
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-6335
Practice Address - Country:US
Practice Address - Phone:907-521-8002
Practice Address - Fax:509-834-7696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-05
Last Update Date:2017-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK115364225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty