Individual
MR. COLE JAYMES CARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
3677 COLLEGE RD, SUITE 12, FAIRBANKS, AK 99709-3712
(907) 479-3800
(907) 479-9195
Mailing address
3677 COLLEGE RD, SUITE 12, FAIRBANKS, AK 99709-3712
(907) 479-3800
(907) 479-9195
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
306
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1972643138
NPI # EQUINOX, INC
AK
05
—
PT0306
—
AK
Enumeration date
05/01/2007
Last updated
11/19/2007
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