ETHAN SHANE BLEVINS

BETHEL, AK
NPI1164952966
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
Enumeration Date2017-06-14
Last Update Date2017-06-14
Business Address
ETHAN SHANE BLEVINS
381 4TH AVE
BETHEL, AK 99559
Phone number: 907-543-2242
Mailing Address
ETHAN SHANE BLEVINS
PO BOX 528 ATTN: BH BAUTISTA
BETHEL, AK 99559
Phone number:
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