Provider Demographics
NPI:1841701166
Name:MASSAGE MATTERS L.L.C.
Entity type:Organization
Organization Name:MASSAGE MATTERS L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAKEN
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:AMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:907-344-0376
Mailing Address - Street 1:7801 SCHOON ST STE B
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-3039
Mailing Address - Country:US
Mailing Address - Phone:907-344-0376
Mailing Address - Fax:907-344-0708
Practice Address - Street 1:7801 SCHOON ST STE B
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-3039
Practice Address - Country:US
Practice Address - Phone:907-344-0376
Practice Address - Fax:907-344-0708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1059154225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1059154OtherBUSINESS LICENSE
AK10056068OtherBUSINESS LICENSE