PEDIATRIC NEUROLOGY CLINIC OF ALASKA, P.C.
Ambulatory Health at 42 Ave, Anchorage, AK

License number
Alaska 4904
Category
Ambulatory Health
Type
Medical Specialty
Owner
Name: RODERIC SMITH III M.D.
Title: PRESIDENT
Phone: (907) 562-6310
Address
Address
2401 E 42Nd Ave SUITE 306, Anchorage, AK 99508
National Provider ID: 1164769204
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PEDIATRIC NEUROLOGY CLINIC OF ALASKA, PC

Anchorage, AK

Registration:
Apr 26, 2002
Addresses:
PO Box 231735, Anchorage, AK 99523 (Mailing)
2401 E 42 Ave STE 306, Anchorage, AK 99508 (Physical)
State ID:
76288D
Business type:
Professional Corporation
Expiration:
Perpetual
Director, President, Shareholder, Secretary, Treasurer, Vice President:
Roderic L Smith (Director, President, Shareholder, Secretary, Treasurer, Vice President)
Agent:
Dlg Services, Inc,1400 W Benson Blvd STE 370, Anchorage, AK 99503 (Mailing)
Next Report:
20160102

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