Individual
MILDRED MARGARET VANDERGON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
12103 HORSESHOE DR, SUITE B, EAGLE RIVER, AK 99577-7547
(907) 696-3657
(907) 622-3657
Mailing address
10620 LONE TREE DR, ANCHORAGE, AK 99507-6924
(907) 346-4509
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1001
AK
Other
Enumeration date
11/16/2012
Last updated
11/16/2012
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