Wendell Street Psychiatric Llc

NPI 1568671766 - Psychiatry & Neurology - 2084P0804X

NPI Details
NPI 1568671766
Enumeration Date 05/22/2007
Last Updated 08/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MIKKI KING MIKKI
Position OWNER PRESIDENT
Phone (907) 455-4135
Fax (907) 455-4115
Practice Location
225 WENDELL ST
STE B
FAIRBANKS AK, 99701-4835, US
Phone (907) 455-4135
Fax (907) 455-4115
Business Location
225 WENDELL ST
STE B
FAIRBANKS AK, 99701-4835, US
Phone (907) 455-4135
Fax (907) 455-4115
Toxanomy
Taxonomy Code 2084P0804X
License State Alaska
License Number 3921
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According to our database, Wendell Street Psychiatric Llc NPI is 1568671766, taxonomy code is 2084P0804X and license number is 3921, license state is located at Alaska. Wendell Street Psychiatric Llc physically located at 225 Wendell St, Fairbanks AK, 99701-4835. NPI Number 1033115704 has the healthcare provider type.

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1568671766 NPI number is provided on an as is basis without warranty of any kind. 1568671766 is maintained by the National Plan & Provider Enumeration System. The contents of Wendell Street Psychiatric Llc are for informational purposes only.