NPI 1215130372

Alaska Brain Center, LLC

Organisation Specialist Wasilla, AK

Practice location

Address: 4551 E Bogard Rd, Wasilla, AK 99654-6075
Phone: (907) 373-6500
Fax: (888) 456-0663

Authorised official

Name: Jeffrey L Sponsler
Title: Owner
Phone: (907) 376-6523

Registered specialties (2)

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 5128 (AK)

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Non-Pharmacy Dispensing Site

Suppliers Taxonomy 332900000X Licence 5128 (AK)

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Registry record

NPI: 1215130372
Entity type: Organization
NPI issued: 7 Jun 2007
Record last updated: 20 Jan 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.