Individual
BRENDA FAYE CROSS BIRDSALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
521 ILLINOIS ST, FAIRBANKS, AK 99701-2914
(907) 374-4911
Mailing address
2320 FAIRBANKS CREEK RD, FAIRBANKS, AK 99712-1753
(907) 389-2000
(907) 389-2002
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
110
AK
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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