Individual
PETER PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4320 DIPLOMACY DR, ANCHORAGE, AK 99508-5925
(907) 729-4955
Mailing address
4320 DIPLOMACY DR, ANCHORAGE, AK 99508-5925
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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