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Individual

MR. JIM T LAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CSA

Contact information

Practice address
1700 E BOGARD RD STE 120, WASILLA, AK 99654-6563
(907) 357-2267
(907) 563-3460
Mailing address
1700 E BOGARD RD STE 120, WASILLA, AK 99654-6563
(907) 357-2267
(907) 563-3460

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
246ZX2200X
Orthopedic Assistant
Primary
3336
AK

Other

Enumeration date
09/17/2013
Last updated
01/12/2016
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