Individual
FORREST L CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10703 S OLD GLENN HWY, PALMER, AK 99645-8228
(907) 745-5715
(907) 745-0518
Mailing address
10703 S OLD GLENN HWY, PALMER, AK 99645-8228
(907) 745-5715
(907) 745-0518
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
232050
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RL7474
—
AK
Enumeration date
03/20/2007
Last updated
07/08/2007
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