Individual
ROBERT GORDON VERNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
650 N SHORELINE DR STE 101, WASILLA, AK 99654-6677
(907) 376-6363
(907) 376-6366
Mailing address
650 N SHORELINE DR STE 101, WASILLA, AK 99654-6677
(907) 376-6363
(907) 376-6366
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1112
AK
Other
Enumeration date
07/19/2010
Last updated
07/19/2010
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