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Organization

MT. SANFORD TRIBAL CONSORTIUM

Active
Other names
Mentasta Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH BEATY (BILLING AGENT)
(907) 770-2380
Entity
Organization

Contact information

Practice address
MILE 7 MENTASTA ROAD, MENTASTA, AK 99780-9803
(907) 822-5399
Mailing address
PO BOX 357, GAKONA, AK 99586-0357

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
04/24/2014
Last updated
04/24/2014
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