Individual
AUDY EMILIO BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4110 DEBARR RD SPC H20, ANCHORAGE, AK 99508-3179
(907) 268-0825
(907) 644-3072
Mailing address
4110 DEBARR RD SPC H20, ANCHORAGE, AK 99508-3179
(907) 268-0825
(907) 644-3072
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
1111787
AK
Other
Enumeration date
01/25/2019
Last updated
01/25/2019
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