MEDICARE: MARY LOU SEIFERT

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
1	246RP1900X	Phlebotomy Technician

General Provider Information

NPI Number	:	1538497748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY LOU SEIFERT

Provider Business Mailing Address
First Line	:	PO BOX 240023
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99524-0023
Country	:	US
Telephone Number	:	907-440-4420
Fax Number	:	907-563-6777

Provider Business Practice Location Address
First Line	:	1917 ABBOTT RD STE 101
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-3448
Country	:	US
Telephone Number	:	907-440-4420
Fax Number	:	907-563-6777

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2009
Last Update Date	:	11/28/2009

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Directions to “ MARY LOU SEIFERT ” Practice Location

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