Alaska Brain Center, LLC

NPI #1215130372 in Wasilla, Alaska

Provider Information

NPI Number: 1215130372
Entity Type: Organization
Organization Name: Alaska Brain Center, LLC
Primary Specialty: Specialist
Enumeration Date: Jun 7, 2007
Last Updated: Jan 20, 2011

Practice Location

Address: 4551 E BOGARD RD
City: Wasilla
State: Alaska
ZIP Code: 99654-6075
Phone: (907) 373-6500

Authorized Official

Name: MR. JEFFREY L SPONSLER, M.D., M.S.
Title: OWNER
Phone: (907) 376-6523

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Non-Pharmacy Dispensing Site	332900000X
Specialist	174400000X	Primary

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