Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 30 | AK |
NPI | 1104872183 |
---|---|
Provider Name | Dr. Scott D Luper |
First Address | Fairbanks, AK 99701-3169 |
Second Address | Fairbanks, AK 99701-3169 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30 | STATE NATUROPATH LICENSE (01) | AK |