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Individual

DIANE A LITTLE EAGLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3550 AIRPORT WAY, 4, FAIRBANKS, AK 99709-4772
(907) 479-2331
Mailing address
3550 AIRPORT WAY, 4, FAIRBANKS, AK 99709
(907) 479-2331
(907) 479-0164

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
ACUA25
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1643831
AK
Enumeration date
07/07/2016
Last updated
07/07/2016
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