Individual
AMANDA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
124 AKHIOK STREET, AKHIOK, AK 99615
(907) 836-2230
(907) 836-2224
Mailing address
PO BOX 5014, AKHIOK, AK 99615-5014
(907) 836-2230
(907) 836-2224
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
15-1355-II
AK
Other
Enumeration date
06/07/2016
Last updated
06/07/2016
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