Individual
YELENA PETKOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
270 FAIRHILL RD, FAIRBANKS, AK 99712-1614
(907) 457-1158
(907) 457-1198
Mailing address
607 OLD STEESE HWY STE B176, FAIRBANKS, AK 99701-3163
(907) 457-1158
(907) 457-1198
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/22/2019
Last updated
05/22/2019
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