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Olivia Bounthanom
NPI 1235642034 · on the registry since 2017 · sole proprietor
Practice
- Address
- 4110 Bullard Ave Unit B
Jber, AK 99506 - Phone
- (907) 351-8383
- Fax
- (907) 351-8383
Registry record
- Primary taxonomy
- 225700000X
225700000X
- Licence states on file
- AK
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2017-11-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Alaska