Provider Demographics
NPI:1821572553
Name:O'BRIEN, CHRISTY (LMT, CERTIFIED ROLFE)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LMT, CERTIFIED ROLFE
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 211496
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99521-1496
Mailing Address - Country:US
Mailing Address - Phone:530-919-1045
Mailing Address - Fax:907-313-1369
Practice Address - Street 1:1200 AIRPORT HEIGHTS RD, SUITE 240
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:530-919-1045
Practice Address - Fax:907-313-1369
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK115498225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist