Individual
MR. TODD LEE SEVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8531 LITTLE DIPPER AVE, ANCHORAGE, AK 99504-4238
(907) 222-1153
Mailing address
PO BOX 210101, ANCHORAGE, AK 99521-0101
(907) 317-5050
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
AK
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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