Individual
GLENN WRIGHTSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1584 HILTON AVE, FAIRBANKS, AK 99701-4016
(907) 750-7488
Mailing address
PO BOX 73331, FAIRBANKS, AK 99707-3331
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
CMGX
AK
Other
Enumeration date
02/23/2016
Last updated
02/23/2016
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