Provider Demographics
NPI:1437540838
Name:EMPOWER LLC
Entity Type:Organization
Organization Name:EMPOWER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING MEMBER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:HAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-631-4263
Mailing Address - Street 1:1075 S CHECK ST STE 208
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-8067
Mailing Address - Country:US
Mailing Address - Phone:907-631-4263
Mailing Address - Fax:907-631-4262
Practice Address - Street 1:1075 S CHECK ST STE 208
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-8067
Practice Address - Country:US
Practice Address - Phone:907-631-4263
Practice Address - Fax:907-631-4262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-07
Last Update Date:2015-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1014993225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty