Provider First Line Business Practice Location Address:
EAST 2ND AVENUE
Provider Second Line Business Practice Location Address:
RUTH QUAMIIGGAN HENRY MEMORIAL CLINIC
Provider Business Practice Location Address City Name:
KOYUK
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-963-3311
Provider Business Practice Location Address Fax Number:
907-963-3610
Provider Enumeration Date:
09/16/2016