Individual
MARLENE LOOMIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
138 W MARYDALE AVE, SOLDOTNA, AK 99669-7501
(907) 280-9490
Mailing address
PO BOX 142, STERLING, AK 99672-0142
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
101646
AK
Other
Enumeration date
06/21/2016
Last updated
06/21/2016
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