Individual
THOMAS WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
505 ILLINOIS ST STE 4, FAIRBANKS, AK 99701-2946
(907) 451-7000
Mailing address
505 ILLINOIS ST STE 4, FAIRBANKS, AK 99701-2946
(907) 451-7000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
225700000X
Massage Therapist
Primary
109356
AK
Other
Enumeration date
06/22/2016
Last updated
06/22/2016
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