Individual
ANDREA STAUNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 E BOGARD RD, WASILLA, AK 99654-7108
(907) 357-2578
(907) 357-2529
Mailing address
401 E BOGARD RD, WASILLA, AK 99654-7108
(907) 357-2578
(907) 357-2529
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2172
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PT 0097
—
AK
Enumeration date
07/09/2010
Last updated
06/24/2014
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