Provider First Line Business Practice Location Address:
MILE 0 AK PENINSULA HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NAKNEK
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99633
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-246-4224
Provider Business Practice Location Address Fax Number:
907-246-6633
Provider Enumeration Date:
04/24/2013