Individual
AGNES GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4155 TUDOR CENTRE DR, ANCHORAGE, AK 99508-5912
(907) 729-4955
Mailing address
4155 TUDOR DR, ANCHORAGE, AK 99508-5912
(907) 729-4955
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/03/2019
Last updated
06/03/2019
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