Provider Demographics
NPI:1750641460
Name:RASCH, HEATHER KULSHAN (CMT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:KULSHAN
Last Name:RASCH
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35477 KENAI SPUR HWY STE 216
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7644
Mailing Address - Country:US
Mailing Address - Phone:907-252-4460
Mailing Address - Fax:907-260-4093
Practice Address - Street 1:35477 KENAI SPUR HWY STE 216
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7644
Practice Address - Country:US
Practice Address - Phone:907-252-4460
Practice Address - Fax:907-260-4093
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC431644-00173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist