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Organization
MCKINLEY SPORTS MEDICINE, LLC
Active
Organization
MCKINLEY SPORTS MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER K MALCOLM DO (PRESIDENT)
(907) 456-3341
Entity
Organization
Contact information
Practice address
3745 GEIST RD, FAIRBANKS, AK 99709-3554
(907) 456-3341
(907) 456-3443
Mailing address
3745 GEIST RD, FAIRBANKS, AK 99709-3554
(907) 456-3341
(907) 456-3443
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
10040231
AK
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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