Most Relevant Information
Provider Data
| NPI Number: | 1003527334 |
| Provider Name: | TRALESSA MARY MAHAN |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: | 1712359 |
Most Important Dates
| Enumeration Date: | 12/07/2022 |
| Last Updated: | 12/07/2022 |
Provider Practice Location
44661 STERLING HWY STE A
SOLDOTNA
AK
996697900
Practice Location Phone/Fax
| Phone: | 9079295826 |
| Fax: |
Provider Mailing Location
44661 STERLING HWY STE A
SOLDOTNA
AK
996697900
Provider Mailing Phone/Fax
| Phone: | 9079295826 |
| Fax: |