Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 129 | AK |
N | 111NR0400X | Rehabilitation Chiropractor | 407 | HI |
NPI | 1275661142 |
---|---|
Provider Name | Dr. Thomas Rogers Gundelfinger |
First Address | Juneau, AK 99801-8050 |
Second Address | Juneau, AK 99801-8050 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CH0084 | (05) | AK |
T67020 | (02) | AK |