Individual
JAN REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8300 NADINE ST, ANCHORAGE, AK 99507-3229
(907) 222-6683
Mailing address
8300 NADINES ST, ANCHORAGE, AK 99507
(907) 222-6683
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
7541948
AK
Other
Enumeration date
02/29/2016
Last updated
02/29/2016
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