Organization
MT.SANFORD TRIBAL CONSORTIUM
Active
Other names
Chistochina Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH BEATY (BILLING AGENT)
(907) 770-2380
Entity
Organization
Contact information
Practice address
MILEPOST 33 TOK CUTOFF, CHISTOCHINA, AK 99586-0000
(907) 822-3599
Mailing address
PO BOX 357, GAKONA, AK 99586-0357
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/24/2014
Last updated
04/24/2014
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