Provider Demographics
NPI:1134357866
Name:OSBORNE, LINDA ANNETTE (LMT)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ANNETTE
Last Name:OSBORNE
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:PO BOX 210856
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99521-0856
Mailing Address - Country:US
Mailing Address - Phone:907-830-8350
Mailing Address - Fax:
Practice Address - Street 1:7731 E NORTHERN LIGHTS BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-3554
Practice Address - Country:US
Practice Address - Phone:907-830-8350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK741277225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist