Individual
GAYNOR JACQUELINE JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7731 E NORTHERN LIGHTS BLVD STE 2, ANCHORAGE, AK 99504-3572
(907) 245-5555
(907) 333-5755
Mailing address
7731 E NORTHERN LIGHTS BLVD STE 2, ANCHORAGE, AK 99504-3572
(907) 245-5555
(907) 333-5755
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
129441
AK
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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