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>> Technician, Other >> Technologists, Technicians & Other Technical Service Providers

Registrant NPI Number: 1609947514

Individual Registrant:
Gender: M
Not Sole Proprietor

Location and contact information for practice:
Tel: 907-487-5757  Fax: 907-487-5360

Contact information for business:
Tel: 907-487-5757  Fax: 907-487-5360

Registration Information:
NPI: 1609947514
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y247200000XTechnologists, Technicians & Other Technical Service Providers
Technician, Other

Legacy codes, insurance codes and state license numbers:



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