Provider Demographics
NPI:1134456148
Name:FORSLIN, DEBORAH JEANNE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:JEANNE
Last Name:FORSLIN
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12805 E ALLISON CT
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-9024
Mailing Address - Country:US
Mailing Address - Phone:907-841-2957
Mailing Address - Fax:
Practice Address - Street 1:472 N MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7018
Practice Address - Country:US
Practice Address - Phone:907-841-2957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK932312172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist