Individual
JORDAN MANELICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8083
(907) 631-7800
Mailing address
1001 KNIK GOOSE BAY RD, WASILLA, AK 99654
(907) 631-7800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/29/2014
Last updated
07/21/2022
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