Organization
NORTHERN LIGHTS PAIN MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT VALENTZ MD (OWNER)
(907) 770-9600
Entity
Organization
Contact information
Practice address
1320 22ND AVE, FAIRBANKS, AK 99701-6516
(907) 452-4777
(907) 452-4787
Mailing address
PO BOX 71434, FAIRBANKS, AK 99707-1434
(907) 770-9600
(907) 277-2629
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
297874
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
297874
AK BUSINESS LICENSE
AK
Enumeration date
10/27/2009
Last updated
10/27/2009
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