Provider Demographics
NPI:1972032431
Name:NOSICH, AMANDA LYNN UNSER (LMT)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LYNN UNSER
Last Name:NOSICH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 E TUDOR RD STE 33
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1069
Mailing Address - Country:US
Mailing Address - Phone:907-519-8049
Mailing Address - Fax:907-782-4148
Practice Address - Street 1:2207 E TUDOR RD STE 33
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1069
Practice Address - Country:US
Practice Address - Phone:907-519-8049
Practice Address - Fax:907-782-4148
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK102122225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist