Individual
ISMAEL LACANLALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4100 LAKE OTIS PKWY STE 106, ANCHORAGE, AK 99508-5230
(907) 563-4115
Mailing address
4400 W LAKE CIR, ANCHORAGE, AK 99502-4910
(907) 887-9802
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
202494
AK
Other
Enumeration date
05/19/2023
Last updated
06/21/2023
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