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Individual

LISA THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11462 BUSINESS BLVD, EAGLE RIVER, AK 99577-7721
(907) 315-5482
Mailing address
11462 BUSINESS BLVD, EAGLE RIVER, AK 99577-7721
(907) 315-5482

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
101539
AK

Other

Enumeration date
03/23/2017
Last updated
03/23/2017
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