Individual
MR. LOTH SAYAVONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4121 CRANNOG ST, ANCHORAGE, AK 99502-5174
(907) 885-8420
(907) 336-7296
Mailing address
PO BOX 231741, ANCHORAGE, AK 99523-1741
(907) 885-8420
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
01/30/2020
Last updated
01/30/2020
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