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1215204664
DEWAYNE GENE JIMMIE
FAIRBANKS, AK
NPI
1215204664
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2011-11-29
Last Update Date
2011-11-29
Business Address
-- DEWAYNE GENE JIMMIE
122 1ST AVE SUITE 400
FAIRBANKS, AK 99701-4803
Phone number: 907-452-8251
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Mailing Address
-- DEWAYNE GENE JIMMIE
122 1ST AVE SUITE 400
FAIRBANKS, AK 99701-4803
Phone number: 907-452-8251
Copy
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