Individual
MADALYN TICKNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1734 FALL RD, FAIRBANKS, AK 99709-6727
(907) 371-4977
Mailing address
PO BOX 84813, FAIRBANKS, AK 99708-4813
(907) 371-4977
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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