TERRENCE EDWARD CLACK

FAIRBANKS, AK
NPI1962112813
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy172V00000X Community Health Worker
(Licence: AK  5530941)
Enumeration Date2022-12-01
Last Update Date2022-12-01
Business Address
Mr. TERRENCE EDWARD CLACK
1825 MARIKA RD
FAIRBANKS, AK 99709-5521
Phone number: 907-474-0890
Mailing Address
Mr. TERRENCE EDWARD CLACK
1825 MARIKA RD
FAIRBANKS, AK 99709-5521
Phone number: 907-474-0890
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