Provider First Line Business Practice Location Address:
PO BOX KXA
Provider Second Line Business Practice Location Address:
HEALTH CLINIC IN CARE OF JASON MORIN
Provider Business Practice Location Address City Name:
KETCHIKAN
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99950-0340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-542-2222
Provider Business Practice Location Address Fax Number:
907-542-2223
Provider Enumeration Date:
03/13/2013