Organization
ALGONE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN THOMAS GRISSOM MD (PRESIDENT)
(907) 373-9460
Entity
Organization
Contact information
Practice address
3066 E MERIDIAN PARK LOOP, #1, WASILLA, AK 99654-7299
(907) 373-9460
(907) 373-9461
Mailing address
PO BOX 870904, WASILLA, AK 99687-0904
(907) 373-9460
(907) 373-9461
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
10/23/2010
Last updated
03/01/2011
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