| Pediatric Resource Center Of Alaska | |
|
1975 W Church Ridge Dr Wasilla AK 99654-2102 | |
| (907) 414-9554 | |
| Not Available |
| Full Name | Pediatric Resource Center Of Alaska |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1975 W Church Ridge Dr, Wasilla, Alaska |
| Authorized Official Name and Position | Marshal Packa (EXECUTIVE MANAGER) |
| Authorized Official Contact | 9074140203 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Resource Center Of Alaska 1975 W Church Ridge Dr Wasilla AK 99654-2102 Ph: (907) 414-9554 | Pediatric Resource Center Of Alaska 1975 W Church Ridge Dr Wasilla AK 99654-2102 Ph: (907) 414-9554 |
| NPI Number | 1720600570 |
|---|---|
| Provider Enumeration Date | 05/15/2020 |
| Last Update Date | 05/15/2020 |
| Certification Date | 05/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720600570 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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