Provider Demographics
NPI:1275218620
Name:FEOLA, XENIA (LMT)
Entity Type:Individual
Prefix:
First Name:XENIA
Middle Name:
Last Name:FEOLA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:XENIA
Other - Middle Name:
Other - Last Name:STARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6701 DICKERSON DR APT 2
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-1186
Mailing Address - Country:US
Mailing Address - Phone:312-383-9589
Mailing Address - Fax:
Practice Address - Street 1:4007 OLD SEWARD HWY STE 100
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-6077
Practice Address - Country:US
Practice Address - Phone:907-770-0858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK210675225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist