Provider First Line Business Practice Location Address:
4076 NEELY ROAD
Provider Second Line Business Practice Location Address:
ATTN: DEPT OF BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
FORT WAINWRIGHT
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-512-1444
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/16/2016