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1063136570
JEWELL DOUGLAS BRADFORD
WASILLA, AK
NPI
1063136570
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2022-09-28
Last Update Date
2022-09-28
Business Address
JEWELL DOUGLAS BRADFORD
1363 W SPRUCE AVE
WASILLA, AK 99654-5327
Phone number: 907-376-2411
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Mailing Address
JEWELL DOUGLAS BRADFORD
PO BOX 870591
WASILLA, AK 99687-0591
Phone number: 907-671-3338
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