Elizabeth Marie Spofford, LMT

Individual provider Active NPI Massage Therapist · Ninilchik, AK

NPI 1194501064 · NPPES record last updated Sep 6, 2023

Key facts

NPI
1194501064
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
113212 (AK)
Practice address
15971 Sterling Hwy
Ninilchik, AK 99639-9963
Phone
(907) 567-3455
NPI assigned
Sep 6, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
113212AKMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225700000X 113212 AK Yes

Addresses

Primary practice location

15971 Sterling Hwy
Ninilchik, AK 99639-9963

Mailing address

PO Box 39558
Ninilchik, AK 99639-0558
Phone (907) 252-9544

Other providers in Ninilchik, AK

All providers in Ninilchik, AK · Massage Therapist in Alaska

Sources for this page

Verify at the official NPI Registry.