Individual
MR. WESLEY JAMES BREEDLOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CHA 3
Contact information
Practice address
5530 GRAHAM ROAD, PORT GRAHAM, AK 99603
(907) 284-2241
(907) 284-2277
Mailing address
PO BOX 5508, PORT GRAHAM, AK 99603-5508
(907) 284-2241
(907) 284-2277
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
08-948-11
AK
Other
Enumeration date
05/01/2009
Last updated
05/01/2009
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