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Individual

MR. TOMMIE L BISHOP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1533 LATOUCHE ST APT C, ANCHORAGE, AK 99501-5588
(907) 272-6377
(866) 496-4107
Mailing address
PO BOX 202056, ANCHORAGE, AK 99520-2056
(907) 223-6377

Taxonomy

Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
101017
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1871195420
AK
Enumeration date
02/18/2021
Last updated
02/18/2021
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