Organization
FULL SPECTRUM HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY WIESE ANP (OWNER)
(907) 727-4239
Entity
Organization
Contact information
Practice address
307 E NORTHERN LIGHTS BLVD STE 201, ANCHORAGE, AK 99503-2701
(907) 229-9766
(888) 974-0807
Mailing address
307 E NORTHERN LIGHTS BLVD STE 201, ANCHORAGE, AK 99503-2701
(907) 229-9766
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022312
—
AK
Enumeration date
11/20/2017
Last updated
11/20/2017
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