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Individual

GRACE KIRK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CHP

Contact information

Practice address
23 MAIN STREET, DEERING, AK 99736
(907) 363-2137
Mailing address
PO BOX 587, KOTZEBUE, AK 99752-0587
(907) 442-6017

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
02552P
AK

Other

Enumeration date
11/28/2011
Last updated
11/28/2011
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