Provider First Line Business Practice Location Address:
550 W 7TH AVE STE 1800
Provider Second Line Business Practice Location Address:
STATE OF ALASKA DEPARTMENT OF CORRECTIONS
Provider Business Practice Location Address City Name:
ANCHORAGE
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99501-3569
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-744-5598
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/08/2011