Doctor Name: | DOMNA REUTOV |
NPI Number: | 1710357827 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 101777 |
Business Practice Address: | 110 W Tudor Rd Ste D Anchorage, AK - 995037247 |
Business Phone Number: | 9073346492 |
Business Fax Number: | |
Mailing Address: | 6085 Spruce Meadows Loop, ANCHORAGE |
State: | AK |
Postal Code: | 995074712 |
Phone Number: | 9073991190 |
Fax Number: | |
NPI Enumeration Date: | 10/01/2015 |
NPI Last Update Date: | 10/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 101777 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |