Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 184279 | AK |
NPI | 1073276937 |
---|---|
Provider Name | Meagan Victoria Brewster |
First Address | Fairbanks, AK 99701-3175 |
Second Address | Fairbanks, AK 99701-3175 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2021 |
Last Update Date | 18/10/2021 |