Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 2198 | AK |
N | 225XP0200X | Occupational Therapist - Pediatrics | 2198 | AK |
NPI | 1134471774 |
---|---|
Provider Name | Dr. Randy Lee Apodaca |
First Address | Cordova, AK 99574-0421 |
Second Address | Cordova, AK 99574 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2012 |
Last Update Date | 13/03/2013 |