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1972112068
JONATHAN WIDMAN
FAIRBANKS, AK
NPI
1972112068
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2020-07-24
Last Update Date
2020-07-24
Business Address
JONATHAN WIDMAN
3101 LATHROP ST
FAIRBANKS, AK 99701-7426
Phone number: 907-459-4700
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Mailing Address
JONATHAN WIDMAN
3101 LATHROP ST
FAIRBANKS, AK 99701-7426
Phone number: 907-459-4700
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