Individual
THOMAS BENROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCP
Contact information
Practice address
4421 MARS DR, ANCHORAGE, AK 99507-3720
(907) 242-7821
Mailing address
4421 MARS DR, ANCHORAGE, AK 99507-3720
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
LP055
NV
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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