Provider Demographics
NPI:1467920140
Name:HWANG, MIN JIN (LMT)
Entity Type:Individual
Prefix:
First Name:MIN JIN
Middle Name:
Last Name:HWANG
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E DIMOND BLVD STE 12
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-1948
Mailing Address - Country:US
Mailing Address - Phone:907-341-7757
Mailing Address - Fax:907-341-7760
Practice Address - Street 1:300 E DIMOND BLVD STE 12
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1948
Practice Address - Country:US
Practice Address - Phone:907-341-7757
Practice Address - Fax:907-341-7760
Is Sole Proprietor?:No
Enumeration Date:2018-11-11
Last Update Date:2018-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK136526225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist