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Individual

JIM TROMBLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
805 FRONTAGE RD STE 208, KENAI, AK 99611-9104
(907) 283-0809
Mailing address
805 FRONTAGE RD STE 208, KENAI, AK 99611-9104
(907) 283-0809

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CM6101
STATE OF ALASKA
AK
Enumeration date
08/27/2009
Last updated
08/27/2009
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