Individual
TAMMY BACKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
302 RAILWAY AVENUE, SEWARD, AK 99664
(907) 422-1010
Mailing address
PO BOX 2731, SEWARD, AK 99664-2731
(907) 654-4198
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/25/2019
Last updated
04/25/2019
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