Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 13530 | AK |
NPI | 1124504618 |
---|---|
Provider Name | Hannah Iverson |
First Address | Anchorage, AK 99518-2283 |
Second Address | Anchorage, AK 99518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2018 |
Last Update Date | 17/07/2018 |