Individual
RELL D STURDEVANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11267 W BIG DIPPER DR, WASILLA, AK 99623-4914
(907) 841-7144
Mailing address
11267 W BIG DIPPER DR, WASILLA, AK 99623-4914
(907) 841-7144
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/29/2019
Last updated
04/29/2019
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