Individual
JACK CRESWELL III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2550 LAWLOR RD, FAIRBANKS, AK 99709-6458
(907) 452-0800
Mailing address
797 JUNIPER DR APT E, FAIRBANKS, AK 99712-2764
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/15/2025
Last updated
08/15/2025
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