Individual
REX SAN DIEGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
8050 PIONEER DR APT 402A, ANCHORAGE, AK 99504-4756
(907) 444-5591
Mailing address
8050 PIONEER DR APT 402A, ANCHORAGE, AK 99504-4756
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
NURP7116
AK
Other
Enumeration date
11/16/2015
Last updated
11/16/2015
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