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Individual

KELANI SHANER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
3750 E COUNTRY FIELD CIR, WASILLA, AK 99654-6659
(907) 376-7334
Mailing address
PO BOX 879674, WASILLA, AK 99687-9674
(907) 312-0940

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
104003
AK

Other

Enumeration date
06/09/2016
Last updated
01/27/2019
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