Individual
MRS. KATHLENE KRYN QUALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 N. BOGARD, WASILLA, AK 99654-7108
(907) 357-2578
Mailing address
401 N. BOGARD, WASILLA, AK 99654-7108
(907) 357-2578
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
861
AK
Other
Enumeration date
10/23/2014
Last updated
07/22/2016
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