Organization
HEATHER L. WOLLER, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEATHER L WOLLER MD (OWNER)
(907) 687-0672
Entity
Organization
Contact information
Practice address
3101 LATHROP ST, FAIRBANKS, AK 99701-7426
(907) 687-0672
Mailing address
PO BOX 84315, FAIRBANKS, AK 99708-4315
(907) 687-0672
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6149
AK
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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