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Individual

ANTHONY GASTELUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
101 TOTEM ST., KAKE CLINIC, KAKE, AK 99830
(907) 785-6515
(907) 785-3350
Mailing address
PO BOX 589, KAKE, AK 99830-0589
(907) 785-6515
(907) 785-3350

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YA0400X
AK
101Y00000X
Counselor

Other

Enumeration date
09/30/2015
Last updated
09/30/2015
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