Individual
DR. IAN CIRASUNDA DETTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5955 ZEAMER AVE, JBER, AK 99506-3702
(907) 580-6800
Mailing address
5955 ZEAMER AVE, JBER, AK 99506-3702
(907) 580-6800
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHA.0024591
CO
Other
Enumeration date
04/12/2023
Last updated
10/25/2024
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