Individual
MS. SANDRA E KILANOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7362 W PARKS HWY # 204, WASILLA, AK 99654-9132
(907) 357-7478
Mailing address
5900 W LOCKSLEY LOOP, WASILLA, AK 99654
(907) 357-7477
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
741871
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851518815
—
AK
Enumeration date
01/15/2009
Last updated
01/15/2009
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