Individual
WENDY DENISE STOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
436 N MAIN ST, WASILLA, AK 99654-7018
(907) 376-8020
Mailing address
436 MAIN ST, WASILLA, AK 99654
(907) 376-8020
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
101828
AK
Other
Enumeration date
11/23/2016
Last updated
11/23/2016
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