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MS. SUMMER ANN MACK CHA II

>> Community Health Worker >> Other Service Providers

Registrant NPI Number: 1154636207

Individual Registrant:
MS. SUMMER ANN MACK CHA II
Gender: F
Not Sole Proprietor

Location and contact information for practice:
100 SLOCUM DRIVE  KING COVE, AK 99612 US
Tel: 907-497-2311  Fax: 907-497-2310

Contact information for business:
3380 C ST STE 100  ANCHORAGE, AK 99503-3949 US
Tel: 907-497-2311  Fax: 907-497-2310

Registration Information:
NPI: 1154636207
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y172V00000XOther Service Providers
Community Health Worker

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
CL9107AK05




HEALTH CARE JOBS AK - Page 1



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