Provider Demographics
NPI:1912371014
Name:MCAFEE MASSAGE & BODYWORKS
Entity Type:Organization
Organization Name:MCAFEE MASSAGE & BODYWORKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:MCAFEE
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:907-378-5385
Mailing Address - Street 1:3043 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-4737
Mailing Address - Country:US
Mailing Address - Phone:907-378-5385
Mailing Address - Fax:907-374-1815
Practice Address - Street 1:3043 RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4737
Practice Address - Country:US
Practice Address - Phone:907-378-5385
Practice Address - Fax:907-374-1815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-30
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK104453225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty