Individual
MRS. VANESSA H MCTAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
398 HAMILTON AVE, FAIRBANKS, AK 99701-3537
(907) 374-4911
Mailing address
398 HAMILTON AVE, FAIRBANKS, AK 99701-3537
(907) 374-4911
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
103781
AK
Other
Enumeration date
11/19/2015
Last updated
11/19/2015
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