Jonathan Lee Carroll

NPI #1972126704 in Wasilla, Alaska

Provider Information

NPI Number: 1972126704
Entity Type: Individual
Name: Jonathan Lee Carroll
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Case Manager/Care Coordinator
Enumeration Date: May 27, 2020
Last Updated: May 27, 2020

Practice Location

Address: 1363 W SPRUCE AVE
City: Wasilla
State: Alaska
ZIP Code: 99654-5327
Phone: (907) 376-2411

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X	Primary

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