Provider First Line Business Practice Location Address:
HC 89 34300 S TALKEETNA SPUR ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TALKEETNA
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99676
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-733-2273
Provider Business Practice Location Address Fax Number:
907-733-1735
Provider Enumeration Date:
10/12/2011