Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | PHYO2716 | AK |
NPI | 1235753310 |
---|---|
Provider Name | Nathan Hebda |
First Address | Anchorage, AK 99508-4680 |
Second Address | Anchorage, AK 99508-4680 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2020 |
Last Update Date | 03/06/2020 |