Alaskan Sourdough Enterprises

NPI #1558686634 in Kenai, Alaska

Provider Information

NPI Number: 1558686634
Entity Type: Organization
Organization Name: Alaskan Sourdough Enterprises
Primary Specialty: Home Health
Enumeration Date: Apr 1, 2010
Last Updated: Apr 1, 2010

Practice Location

Address: 225 PHILLIPS DR
City: Kenai
State: Alaska
ZIP Code: 99611-8447
Phone: (907) 335-0559

Authorized Official

Name: VINCENT MALONE JOHNSON
Title: OWNER
Phone: (907) 335-0559

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Home Health	251E00000X	Primary

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