Individual ProviderJessica CoullardMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address11806 Glacier Hwy Ste 1b, Juneau, AK 99801-8644(907) 020-9086(907) 209-0866PECOS EnrollmentBased on the most recent information from CMS, provider Jessica Coullard does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1841460524Provider TypeIndividualFull NameCoullard, JessicaCredentialLMTGenderFemaleSole ProprietorYesEnumeration Date3/10/2008Last Updated2/27/2024Contact InformationPractice LocationPractice Address11806 Glacier Hwy Ste 1b, Juneau, AK 99801-8644Phone(907) 020-9086FaxUnlisted FaxMailing LocationMailing AddressPO Box 35643, Juneau, AK 99803-5643Phone(907) 209-0866FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense149089AlaskaCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer