Individual
MADELYN RALSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
595 E PARKS HWY, WASILLA, AK 99654-8150
(907) 352-1160
Mailing address
6581 KARA SUE LOOP, ANCHORAGE, AK 99504-4883
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
145796
AK
Other
Enumeration date
08/20/2019
Last updated
08/20/2019
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