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1891079976
MONTIE DALE FORD
FAIRBANKS, AK
NPI
1891079976
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
322D00000X Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date
2011-10-06
Last Update Date
2011-10-06
Business Address
-- MONTIE DALE FORD CDC 1
1825 MARIKA RD
FAIRBANKS, AK 99709-5521
Phone number: 907-474-0890
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Mailing Address
-- MONTIE DALE FORD CDC 1
1825 MARIKA RD
FAIRBANKS, AK 99709-5521
Phone number: 907-474-0890
Copy
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