Individual
JONATHAN T VICTORINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1867 AIRPORT WAY STE 140C, FAIRBANKS, AK 99701-4055
(907) 455-7770
(907) 451-7770
Mailing address
1867 AIRPORT WAY STE 140C, FAIRBANKS, AK 99701-4055
(907) 455-7770
(907) 451-7770
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
389
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CH5926
—
AK
Enumeration date
08/01/2006
Last updated
12/07/2007
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