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1326702218
JUSTIN PENDERGRASS
WASILLA, AK
NPI
1326702218
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2021-10-26
Last Update Date
2021-10-26
Business Address
JUSTIN PENDERGRASS
591 S KNIK GOOSE BAY RD
WASILLA, AK 99654-8062
Phone number: 907-313-1333
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Mailing Address
JUSTIN PENDERGRASS
591 S KNIK GOOSE BAY RD
WASILLA, AK 99654-8062
Phone number:
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