Provider First Line Business Practice Location Address:
101 FIRST AVE
Provider Second Line Business Practice Location Address:
TANANA HEALTH CLINIC
Provider Business Practice Location Address City Name:
TANANA
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99777-0150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-366-1016
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/11/2006