Individual
MARY MALEMUTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHA III
Contact information
Practice address
100 SPRUCE ST, KOYUKUK, AK 99754
(907) 927-2221
Mailing address
100 SPRUCE ST, KOYUKUK, AK 99754
(907) 927-2221
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
11-1151-III
AK
Other
Enumeration date
01/24/2012
Last updated
01/24/2012
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