Individual
MOMODOU JALLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2591 LYVONA LN, ANCHORAGE, AK 99502-5452
(907) 205-0394
Mailing address
2591 LYVONA LN, ANCHORAGE, AK 99502-5452
(907) 205-0394
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
100880
AK
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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