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Individual

CHESTER JOSEPH WITCZAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2500 S WOODWORTH LOOP, PALMER, AK 99645-8984
(717) 968-7149
(907) 745-0200
Mailing address
610 S BAILEY ST, PALMER, AK 99645-6330
(717) 968-7149
(907) 745-0200

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1122
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
AK
Enumeration date
07/27/2012
Last updated
07/27/2012
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