Individual
MARY PAULINE AGUCHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
150 MAIN RD, SCAMMON BAY CLINIC, SCAMMON BAY, AK 99662-0150
(907) 558-5511
(907) 558-5705
Mailing address
97 HILLSIDE RD, SCAMMON BAY, AK 99662-0097
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9439
—
AK
Enumeration date
02/22/2012
Last updated
12/06/2012
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