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Organization
LEGACY HEALTH CLINIC, LLC
Active
Organization
LEGACY HEALTH CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HELEN R KLEIN FNP (OWNER)
(907) 225-6355
Entity
Organization
Contact information
Practice address
3524 TONGASS AVE, KETCHIKAN, AK 99901-5635
(907) 225-6355
Mailing address
3524 TONGASS AVE, KETCHIKAN, AK 99901-5635
(907) 225-6355
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
1106
AK
363LF0000X
Family Nurse Practitioner
551
AK
Other
Enumeration date
10/01/2015
Last updated
10/01/2015
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