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NPI Code Detail

MEDICARE: DAKOTA J VIKDAL

MEDICARE:   DAKOTA J VIKDAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist
2225700000XMassage Therapist133001AK

General Provider Information

NPI Number : 1033688619
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAKOTA J VIKDAL
Provider Business Mailing Address
First Line : 19827 DOTIES DR
Second Line :
City : CHUGIAK
State : AK
Zip : 99567-5849
Country : US
Telephone Number : 907-306-4620
Fax Number :
Provider Business Practice Location Address
First Line : 2606 SPENARD RD
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-2309
Country : US
Telephone Number : 907-279-7669
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2018
Last Update Date : 11/13/2018

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Directions to “ DAKOTA J VIKDAL ” Practice Location

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