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1700091923
RANDY FANCYBOY
BETHEL, AK
NPI
1700091923
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician Personal Care Attendant
Enumeration Date
2007-05-11
Last Update Date
2024-08-31
Business Address
RANDY FANCYBOY
700 CHIEF EDDIE HOFFMAN HIGHWAY
BETHEL, AK 99559-0287
Phone number: 907-543-6300
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Mailing Address
RANDY FANCYBOY
PO BOX 287
BETHEL, AK 99559-0287
Phone number: 907-543-6300
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