Provider Demographics
NPI:1427561364
Name:RICE, ROSALIE (MASSAGE THERPIST)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:MASSAGE THERPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 407
Mailing Address - Street 2:
Mailing Address - City:ANCHOR POINT
Mailing Address - State:AK
Mailing Address - Zip Code:99556-0407
Mailing Address - Country:US
Mailing Address - Phone:907-299-8284
Mailing Address - Fax:
Practice Address - Street 1:1104 OCEAN DR UNIT A
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:AK
Practice Address - Zip Code:99603-7919
Practice Address - Country:US
Practice Address - Phone:907-299-8284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101551225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist