Individual
ACACIA WYSOCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6000 KANAKANAK ROAD, DILLINGHAM, AK 99576
(907) 842-5201
Mailing address
P.O. BOX 130, DILLINGHAM, AK 99576
(907) 842-5201
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7324454
AK
Other
Enumeration date
05/10/2017
Last updated
04/24/2024
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