Individual
JOVAN KIDDER AILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2521 E MOUNTAIN VILLAGE DR STE F, WASILLA, AK 99654-7373
(907) 290-3760
Mailing address
2778 N AZURITE CIR, WASILLA, AK 99654-4540
(808) 205-9437
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/10/2019
Last updated
07/10/2019
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