Provider First Line Business Practice Location Address:
320 BENNETT ST
Provider Second Line Business Practice Location Address:
POINT BAKER COMMUNITY BUILDING
Provider Business Practice Location Address City Name:
PT BAKER
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-874-4700
Provider Business Practice Location Address Fax Number:
907-874-4719
Provider Enumeration Date:
01/31/2007