Individual
MR. CHARLES EDWARD KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CHP
Contact information
Practice address
9 HILLSIDE ROAD, 86, BUCKLAND, AK 99727
(907) 494-2122
(907) 494-2104
Mailing address
9 HILLSIDE ROAD, BOX 86, BUCKLAND, AK 99727
(907) 494-2122
(907) 494-2104
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
04-677-P
AK
Other
Enumeration date
12/09/2011
Last updated
12/09/2011
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