Individual
JONATHAN SQUIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1717 W COWLES ST, FAIRBANKS, AK 99701-5926
(907) 451-6682
Mailing address
1717 W COWLES ST, FAIRBANKS, AK 99701-5926
(907) 451-6682
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
Primary
MEDM852
AK
Other
Enumeration date
08/14/2015
Last updated
08/14/2015
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