Provider First Line Business Practice Location Address:
4300 BARTLETT STREET
Provider Second Line Business Practice Location Address:
C/O SPH- HOMEHEALTH
Provider Business Practice Location Address City Name:
HOMER
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-235-0369
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/01/2011