Tanana Valley Clinic LLC

NPI #1073081287 in Fairbanks, Alaska

Provider Information

NPI Number: 1073081287
Entity Type: Organization
Organization Name: Tanana Valley Clinic LLC
Subpart: Yes (part of a larger organization)
Parent Organization: FOUNDATION HEALTH LLC
Primary Specialty: Clinic/Center - Multi-Specialty
Enumeration Date: Nov 6, 2018
Last Updated: Nov 6, 2018

Practice Location

Address: 1405 KELLUM ST
City: Fairbanks
State: Alaska
ZIP Code: 99701-4189
Phone: (907) 459-3500

Authorized Official

Name: STEPHEN PAUL LESLIE
Title: CFO
Phone: (907) 458-3310

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Multi-Specialty — Multi-Specialty	261QM1300X	Primary

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