Organization
GLACIER SURGICAL ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON CHRISTINE GULLEY MD (PRESIDENT)
(907) 746-1520
Entity
Organization
Contact information
Practice address
425 E DAHLIA AVE STE J, PALMER, AK 99645-6463
(907) 746-1520
(907) 746-1521
Mailing address
PO BOX 75032, CHICAGO, IL 60675-5032
(907) 746-1520
(907) 746-1521
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
8370
AK
Other
Enumeration date
08/20/2014
Last updated
07/15/2025
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