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1932864220
JOHNNY RICHARD CLYDE
FAIRBANKS, AK
NPI
1932864220
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-11-02
Last Update Date
2021-11-02
Business Address
JOHNNY RICHARD CLYDE
1521 HILTON AVE
FAIRBANKS, AK 99701-4015
Phone number: 907-371-1308
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Mailing Address
JOHNNY RICHARD CLYDE
4020 FOLKER ST
ANCHORAGE, AK 99508-5321
Phone number: 907-563-1000
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