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1801481635
ETHAN ALLEN
FAIRBANKS, AK
NPI
1801481635
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2021-03-03
Last Update Date
2021-03-03
Business Address
ETHAN ALLEN
209 FORTY MILE AVE
FAIRBANKS, AK 99701-3110
Phone number: 907-456-6445
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Mailing Address
ETHAN ALLEN
209 FORTY MILE AVE
FAIRBANKS, AK 99701-3110
Phone number: 907-456-6445
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