Individual
JACK WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
5955 ZEAMER AVE, JBER, AK 99506-3702
(907) 580-0005
Mailing address
5955 ZEAMER AVE, JBER, AK 99506-3702
(907) 580-0005
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
11/26/2012
Last updated
06/18/2021
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