Organization
ALASKA BRAIN CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY L SPONSLER M.D., M.S. (OWNER)
(907) 376-6523
Entity
Organization
Contact information
Practice address
4551 E BOGARD RD, WASILLA, AK 99654-6075
(907) 373-6500
(888) 456-0663
Mailing address
4551 E BOGARD RD, WASILLA, AK 99654-6075
(907) 373-6500
(888) 456-0663
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5128
AK
332900000X
Non-Pharmacy Dispensing Site
5128
AK
Other
Enumeration date
06/07/2007
Last updated
01/20/2011
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