Individual
SAMUEL ALEXANDER ISLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
673 MDG, 5955 ZEAMER AVE, JBER, AK 99506
(907) 580-1702
Mailing address
673 MDG, 5955 ZEAMER AVE, JBER, AK 99506
(907) 580-1702
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT61274559
WA
Other
Enumeration date
09/01/2021
Last updated
10/25/2023
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