Individual
MARY ANN MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4519 W AMANDA DR, WASILLA, AK 99623-1046
(208) 713-4603
Mailing address
PO BOX 871282, WASILLA, AK 99687-1282
(208) 713-4603
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
101350
AK
Other
Enumeration date
12/16/2019
Last updated
12/16/2019
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