Provider Demographics
NPI:1053801233
Name:STEINER, MICHELLE MARIE (LMT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:STEINER
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 1:2975 MILL BAY RD STE A
Mailing Address - Street 2:
Mailing Address - City:KODIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99615-7831
Mailing Address - Country:US
Mailing Address - Phone:907-512-0809
Mailing Address - Fax:
Practice Address - Street 1:2975 MILL BAY RD STE A
Practice Address - Street 2:
Practice Address - City:KODIAK
Practice Address - State:AK
Practice Address - Zip Code:99615-7831
Practice Address - Country:US
Practice Address - Phone:907-512-0809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT035271225700000X
AK130243225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist