Most Relevant Information
Provider Data
| NPI Number: | 1003049313 |
| Provider Name: | WANDA K MOORE |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/02/2009 |
| Last Updated: | 09/02/2009 |
Provider Practice Location
540 W INTERNATIONAL AIRPORT RD
ANCHORAGE
AK
995181105
Practice Location Phone/Fax
| Phone: | 9075615335 |
| Fax: | 9075647429 |
Provider Mailing Location
540 W INTERNATIONAL AIRPORT RD
ANCHORAGE
AK
995181105
Provider Mailing Phone/Fax
| Phone: | 9075615335 |
| Fax: | 9075647429 |