Provider First Line Business Practice Location Address:
4320 DIPLOMACY DRIVE
Provider Second Line Business Practice Location Address:
SUITE 1191 PRIMARY CARE CLINIC 1 EAST
Provider Business Practice Location Address City Name:
ANCHORAGE
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-729-3371
Provider Business Practice Location Address Fax Number:
907-729-4140
Provider Enumeration Date:
03/20/2007