Organization
FARTHEST NORTH PROSTHETICS AND ORTHOTICS
Active
Organization
FARTHEST NORTH PROSTHETICS AND ORTHOTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND GILLIGAN (PROSTHETIST ORTHOTIST)
(907) 455-9255
Entity
Organization
Contact information
Practice address
3520 INDUSTRIAL AVE, FAIRBANKS, AK 99701-7376
(907) 455-9255
(907) 455-6532
Mailing address
3520 INDUSTRIAL AVE, FAIRBANKS, AK 99701-7376
(907) 455-9255
(907) 455-6532
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
BL272686
AK
Other
Enumeration date
06/15/2007
Last updated
12/31/2008
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