Individual
LYNNE C DEBOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
540 NORTH PINE RIDGE LOOP, WASILLA, AK 99654
(907) 373-4943
(907) 373-4943
Mailing address
PO BOX 872093, WASILLA, AK 99687-2093
(907) 373-4943
(907) 373-4943
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1799
AK
Other
Enumeration date
02/24/2009
Last updated
08/10/2011
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