Provider Demographics
NPI:1881837961
Name:DANCE, VICTORIA (MA, LMT)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:
Last Name:DANCE
Suffix:
Gender:F
Credentials:MA, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 W WILLOUGHBY AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-1748
Mailing Address - Country:US
Mailing Address - Phone:907-586-8100
Mailing Address - Fax:907-586-8102
Practice Address - Street 1:641 WEST WILLOUGHBY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801
Practice Address - Country:US
Practice Address - Phone:907-586-8100
Practice Address - Fax:907-586-8102
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ#MT-07557225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist