Provider First Line Business Practice Location Address:
51 SPINE ROAD
Provider Second Line Business Practice Location Address:
PRB-9 MCC MEDICAL CLINIC, BOX 340137
Provider Business Practice Location Address City Name:
PRUDHOE BAY
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99734
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-659-5239
Provider Business Practice Location Address Fax Number:
907-659-8211
Provider Enumeration Date:
02/19/2010