Individual
LORI LANDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
201 3RD AVENUE, SUITE 201, SEWARD, AK 99664-2088
(907) 224-3490
(907) 224-5870
Mailing address
PO BOX 2088, SUITE 201, SEWARD, AK 99664-2088
(907) 224-3490
(907) 224-5870
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1346
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CL3490
—
AK
Enumeration date
11/27/2006
Last updated
07/08/2007
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