Individual
CHARLES DAVID ENOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
829 CHIEF EDDIE HOFFMAN HWY, BETHEL, AK 99559
(907) 543-6100
(907) 543-6159
Mailing address
P.O. BOX 528, ATTN: BH PREVENTATIVE SERVICES, BETHEL, AK 99559
(907) 543-6100
(907) 543-6159
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020986
—
AK
Enumeration date
03/02/2018
Last updated
11/30/2020
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