Provider First Line Business Practice Location Address:
PATTY CENTER
Provider Second Line Business Practice Location Address:
ROOMS 225 & 227
Provider Business Practice Location Address City Name:
FAIRBANKS
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99775-7440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-474-2435
Provider Business Practice Location Address Fax Number:
907-474-5162
Provider Enumeration Date:
07/06/2026