Individual
CLINT MATTHEW WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2650 E BROADVIEW AVE, WASILLA, AK 99654-8302
(907) 631-3133
Mailing address
591 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8062
(541) 954-7983
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
164807
AK
Other
Enumeration date
08/08/2023
Last updated
08/08/2023
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