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Individual

MR. DONALD ESAU CHARLIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CDC II,BHA II

Contact information

Practice address
1408 19TH AVE, FAIRBANKS, AK 99701
(907) 459-3800
(907) 832-5477
Mailing address
PO BOX 253, NENANA, AK 99760-0253
(907) 832-5467
(907) 832-5477

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1850
AK

Other

Enumeration date
04/06/2007
Last updated
07/08/2007
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