Provider Demographics
NPI:1770888372
Name:MOSHE-MCINTYRE, ALEXANDRIA (MASSAGE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:MOSHE-MCINTYRE
Suffix:
Gender:F
Credentials:MASSAGE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4240 OLD SEWARD HWY STE 12
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-6053
Mailing Address - Country:US
Mailing Address - Phone:907-830-9614
Mailing Address - Fax:907-344-7235
Practice Address - Street 1:4240 OLD SEWARD HIGHWAY, STE. 12
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-830-9614
Practice Address - Fax:907-344-7235
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKMP1959173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist