Individual
KOBE KEO LIFTEE THAMMAVONGSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4320 DIPLOMACY DR, ANCHORAGE, AK 99508-5925
(907) 729-0000
Mailing address
7033 E TUDOR RD, ANCHORAGE, AK 99507-1262
(907) 729-0000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
159972
AK
Other
Enumeration date
07/27/2020
Last updated
07/27/2020
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