Most Relevant Information
Provider Data
| NPI Number: | 1003287673 |
| Provider Name: | DANIELLE WOLAK |
| Entity Type: | Individual |
| Taxonomy Code: | 247200000X |
| Specialty: | Technician, Other |
| License Number: | RBT-15-05218 |
Most Important Dates
| Enumeration Date: | 10/08/2015 |
| Last Updated: | 03/17/2018 |
Provider Practice Location
4272 TIMBERLAND LOOP
WASILLA
AK
99654
Practice Location Phone/Fax
| Phone: | 9075210890 |
| Fax: |
Provider Mailing Location
4272 TIMBERLAND LOOP
WASILLA
AK
99654
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |