Organization
MANIILAQ ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND COPPOCK CDCI (CDCT)
(907) 442-7640
Entity
Organization
Contact information
Practice address
733 2ND AVE, KOTZEBUE, AK 99752-0256
(907) 442-7640
(907) 442-7749
Mailing address
733 2ND AVE, KOTZEBUE, AK 99752-0256
(907) 442-7640
(907) 442-7749
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/28/2013
Last updated
10/28/2013
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