Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 70 | AK |
NPI | 1053621748 |
---|---|
Provider Name | Dr. Joan Kirk |
First Address | Anchorage, AK 99516-1648 |
Second Address | Palmer, AK 99645-6342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2010 |
Last Update Date | 13/06/2011 |