Individual
MATTHEW BRANDON LISTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4045 LAKE OTIS PKWY, ANCHORAGE, AK 99508-5227
(907) 561-0954
Mailing address
2215 CORDOVA ST, ANCHORAGE, AK 99503-2140
(503) 481-3938
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/04/2010
Last updated
10/04/2010
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