Provider First Line Business Practice Location Address:
3035 E PALMER WASILLA HWY
Provider Second Line Business Practice Location Address:
SUITE 501 ADVANCED PAIN CENTER OF ALASKA
Provider Business Practice Location Address City Name:
WASILLA
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99654-7274
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-357-8330
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/13/2006