Individual
JOE ROBERT GONZALES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTD
Contact information
Practice address
398 HAMILTON AVE, FAIRBANKS, AK 99701-3537
(907) 374-4911
Mailing address
398 HAMILTON AVE, FAIRBANKS, AK 99701-3537
(907) 374-4911
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
113930
AK
Other
Enumeration date
07/29/2016
Last updated
07/29/2016
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