Provider First Line Business Practice Location Address:
124.5 GLENN HIGHWAY
Provider Second Line Business Practice Location Address:
UPPER TANANA HEALTH CENTER
Provider Business Practice Location Address City Name:
TOK
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99780
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-883-5855
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/04/2013