Individual
CHARLES KEITH MOREY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1825 N ROCKSIDE RD, WASILLA, AK 99654-3131
(907) 414-0168
Mailing address
1825 N ROCKSIDE RD, WASILLA, AK 99654-3131
(907) 414-0168
Taxonomy
Speciality
Code
Description
License number
State
344600000X
Taxi
Primary
2100910
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180144
—
AK
Enumeration date
03/11/2020
Last updated
03/11/2020
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