Individual
CHARLES HURST VAN RAVENSWAAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
851 E WESTPOINT DR STE 310, WASILLA, AK 99654-7183
(907) 357-5400
Mailing address
3600 SAN JERONIMO DR, ANCHORAGE, AK 99508-2870
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/07/2019
Last updated
05/07/2019
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