Provider First Line Business Practice Location Address:
MILE 238.8 PARKS HIGHWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENALI
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99755
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-683-4433
Provider Business Practice Location Address Fax Number:
907-683-4434
Provider Enumeration Date:
04/09/2008