Provider Demographics
NPI:1912186545
Name:SALONTAI, LOIS
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:
Last Name:SALONTAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 230707
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99523-0707
Mailing Address - Country:US
Mailing Address - Phone:907-349-0561
Mailing Address - Fax:907-349-0997
Practice Address - Street 1:8671 BARNEY CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-3686
Practice Address - Country:US
Practice Address - Phone:907-349-0561
Practice Address - Fax:907-349-0997
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator