Individual
OLIVIA MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
602 CHASE AVE, CORDOVA, AK 99574-0559
(907) 424-8000
Mailing address
PO BOX 2473, CORDOVA, AK 99574-2473
(907) 382-4002
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
216655
AK
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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