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LARISSA ELLIS WILLIAMS LMT

>> Massage Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1073033783

Individual Registrant:
 LARISSA ELLIS WILLIAMS LMT
Gender: F
Sole Proprietor

Location and contact information for practice:
501 E. BREMNER  VALDEZ, AK 99686-1706 US
Tel: 907-835-8777  Fax: 907-835-8702

Contact information for business:
PO BOX 1706  VALDEZ, AK 99686-1706 US
Tel: 907-835-8777  Fax: 907-835-8702

Registration Information:
NPI: 1073033783
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225700000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Massage Therapist
AK101615

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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