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Individual

MR. JIMMY SPEARS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CDCI

Contact information

Practice address
1027 EVERGREEN ST, FAIRBANKS, AK 99709-4306
(907) 451-8164
Mailing address
PO BOX 71023, FAIRBANKS, AK 99707-1023

Taxonomy

Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
3323
AK

Other

Enumeration date
05/21/2007
Last updated
07/08/2007
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