Provider Demographics
NPI:1568156438
Name:ALASKANS RELAX-ZEN
Entity Type:Organization
Organization Name:ALASKANS RELAX-ZEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:PETTIT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:907-707-3847
Mailing Address - Street 1:10823 E PALMER WASILLA HWY STE 4
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-9498
Mailing Address - Country:US
Mailing Address - Phone:907-707-3847
Mailing Address - Fax:907-313-2733
Practice Address - Street 1:10823 E PALMER WASILLA HWY STE 4
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-9498
Practice Address - Country:US
Practice Address - Phone:907-707-3847
Practice Address - Fax:907-313-2733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty