Daniel Grant Groeneweg

Individual provider Active NPI Massage Therapist · Eagle River, AK

NPI 1346863560 · NPPES record last updated May 21, 2020

Key facts

NPI
1346863560
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
128196 (AK)
Practice address
13135 Old Glenn Hwy Ste 100
Eagle River, AK 99577-7584
Phone
(907) 696-9090
Fax
(907) 696-9091
NPI assigned
May 21, 2020
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
128196AKMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Migraine Specialists, LLC Current
since Dec 26, 2021
Accepting new patients
Hindman Family Chiropractic LLC Past
since May 24, 2020
Accepting new patients

Locations

13135 Old Glenn Hwy
Ste 100
Eagle River, AK 99577
Phone (907) 331-9835

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 128196 AK Yes

Addresses

Primary practice location

13135 Old Glenn Hwy Ste 100
Eagle River, AK 99577-7584

Mailing address

13135 Old Glenn Hwy Ste 100
Eagle River, AK 99577-7584
Phone (907) 696-9090

Other providers in Eagle River, AK

All providers in Eagle River, AK · Massage Therapist in Alaska

Sources for this page

Verify at the official NPI Registry.