Most Relevant Information
Provider Data
| NPI Number: | 1003023391 |
| Provider Name: | JIMMY J. JIMMY |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/17/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
700 CHIEF EDDIE HOFFMAN HIGHWAY
BETHEL
AK
995590287
Practice Location Phone/Fax
| Phone: | 9075436300 |
| Fax: | 9075436366 |
Provider Mailing Location
PO BOX 287
BETHEL
AK
995590287
Provider Mailing Phone/Fax
| Phone: | 9075436300 |
| Fax: | 9075436366 |