TREVOR DALE MUNGER

WASILLA, AK
NPI1962761973
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy222Z00000X Orthotist
(Licence: DE  CPO01700)
Additional Taxonomies224L00000X Pedorthist
(Licence: DE  CPO01700)
224P00000X Prosthetist
(Licence: DE  CPO01700)
Enumeration Date2012-05-10
Last Update Date2012-05-10
Business Address
-- TREVOR DALE MUNGER CPO
1700 E BOGARD RD STE 104 BUILDING B
WASILLA, AK 99654-6563
Phone number: 907-743-9991
Mailing Address
-- TREVOR DALE MUNGER CPO
5701 LAKE OTIS PKWY STE 400
ANCHORAGE, AK 99507-1778
Phone number: 907-743-9991
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