Individual
JOHN DECARLO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
3801 UNIVERSITY LAKE DR, ANCHORAGE, AK 99508-4639
(907) 563-8876
Mailing address
PO BOX 196400, ANCHORAGE, AK 99519-6400
(907) 563-8876
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
694
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OT4546
—
AK
Enumeration date
04/12/2006
Last updated
07/08/2007
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