Individual
RYDER R STORM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
338800 COMMUNITY COLLEGE DRIVE, SUITE 1, SOLDOTNA, AK 99669
(907) 262-0893
Mailing address
PO BOX 2972, SOLDOTNA, AK 99669-2972
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-69487
AK
Other
Enumeration date
11/13/2018
Last updated
11/13/2018
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