Individual
PAUL LICKTEIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
5955 ZEAMER AVE, JBER, AK 99506-3702
(907) 580-1701
Mailing address
5955 ZEAMER AVE, JBER, AK 99506-3702
(907) 580-1701
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1287101
TX
Other
Enumeration date
04/16/2018
Last updated
06/11/2020
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