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Annelle Glee Maygren
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NPI Number Detailed Information
Provider Information:
Name: | Annelle Glee Maygren |
Gender: | F |
Provider License Number If Given: | 297 |
NPI Information:
NPI: | 1477556488 |
Entity Type (Individual or Organization): |
1-ind |
Enumeration Date: | 5/23/2005 |
Last Update Date: | 1/18/2013 |
Provider Business Mailing Address:
Address: | PO BOX 89 Klawock, AK 99925 |
Phone Number: | 9077554967 |
Fax Number: | 9077552414 |
Provider Business Practice Location Address:
Address: | 6488 KLAWOCK HOLLIS HWY #4 Klawock, AK 99925 |
Phone Number: | 9077554967 |
Fax Number: | 9077552414 |
Provider Taxonomy:
Primary: | 152W00000X |
Secondary (if any): | 152W00000X |
State: | AK |