Organization
KETCHIKAN INDIAN CORPORATION
Active
Other names
KIC TRIBAL HEALTH CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVE F HUDSON (HEALTH ADMINISTRATOR)
(907) 228-9253
Entity
Organization
Contact information
Practice address
2960 TONGASS AVE, KETCHIKAN, AK 99901-5742
(907) 228-9200
(800) 887-8796
Mailing address
2960 TONGASS AVE, KETCHIKAN, AK 99901-5742
(907) 228-9200
(800) 887-8796
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
378
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
378
BUSINESS PROFESSIONAL LICENSE
AK
Enumeration date
07/31/2014
Last updated
07/31/2014
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