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Individual

MRS. SUSAN M. BANKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1400 COOPER RIVER HIGHWAY, #1, CORDOVA, AK 99574-2431
(907) 424-4935
(907) 424-7936
Mailing address
PO BOX 2431, CORDOVA, AK 99574-2431
(907) 424-7792
(907) 424-7936

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
CM3359
AK
Enumeration date
11/24/2006
Last updated
07/09/2007
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