Individual
BRENDA LOUISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
206 S 2ND, PETERSBURG, AK 99833
(253) 797-8756
Mailing address
PO BOX 1128, PETERSBURG, AK 99833-1128
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/07/2019
Last updated
11/07/2019
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