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General NPI Number Information
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NPI Number | 1285055723
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Entity Type | Individual
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Provider Name | NOAH HALEY CRT
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Gender | Male
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Dates
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Enumeration Date | 12/31/2013
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Last Update Date | 12/31/2013
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Provider Practice Location Address
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Address Line | 250 HOSPITAL PL
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City | SOLDOTNA
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State | AK
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Zip | 99669-7559
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Country | US
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Telephone | 907-714-4437
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4351
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City | SOLDOTNA
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State | AK
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Zip | 99669-4351
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Country | US
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Telephone | 405-203-6182
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | 3290
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License Number State | OK
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