Individual
LINDA M MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHAP
Contact information
Practice address
40 MAIN ST., NELSON LAGOON, AK 99571
(907) 989-2202
(907) 989-2245
Mailing address
3380 C ST STE 100, ANCHORAGE, AK 99503-3949
(907) 277-1440
(907) 277-1446
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MDG925
—
AK
Enumeration date
04/08/2008
Last updated
04/08/2008
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