Provider First Line Business Practice Location Address:
3200 PROVIDENCE DR
Provider Second Line Business Practice Location Address:
CHILDRENS HOSPITAL
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:
907-261-3067
Provider Business Practice Location Address Fax Number:
907-344-3107
Provider Enumeration Date:
03/24/2006