Individual
JAXON BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
304 W EVERGREEN AVE STE 101, PALMER, AK 99645-6970
(907) 745-8686
Mailing address
304 W EVERGREEN AVE STE 101, PALMER, AK 99645-6970
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
204733
AK
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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