Individual
ANTHONY JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8401 BERRY PATCH DR, ANCHORAGE, AK 99502-7265
(907) 222-1028
(907) 222-1028
Mailing address
8401 BERRY PATCH DR, ANCHORAGE, AK 99502-7265
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
101179
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6800582
DRIVER LICENSE
AK
Enumeration date
12/06/2016
Last updated
08/24/2017
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