Individual
GAVIN HAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3101 LATHROP ST, FAIRBANKS, AK 99701-7426
(907) 459-4700
Mailing address
1825 MARIKA RD, FAIRBANKS, AK 99709-5521
(907) 474-0890
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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