Individual
HEATHER RUTH EDGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13784 W AIRIGIN DR, BIG LAKE, AK 99652
(907) 315-1517
Mailing address
PO BOX 521611, BIG LAKE, AK 99652-1611
(907) 315-1517
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
07/23/2020
Last updated
07/23/2020
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