Basic Information
| Provider Information | |||||||||
| NPI: | 1356587810 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SARKA | ||||||||
| FirstName: | JOYETTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1511 | ||||||||
| Address2: | |||||||||
| City: | SEWARD | ||||||||
| State: | AK | ||||||||
| PostalCode: | 996641511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9072242209 | ||||||||
| FaxNumber: | 9072247081 | ||||||||
| Practice Location | |||||||||
| Address1: | 302 RAILWAY AVE | ||||||||
| Address2: | |||||||||
| City: | SEWARD | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9072245257 | ||||||||
| FaxNumber: | 9072247081 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2009 | ||||||||
| LastUpdateDate: | 01/05/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator | 225800000X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Recreation Therapist |
No ID Information.