Provider Information for 1811105489
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Mr. BRETT WILCOX M.Ed.
Sex: Male
NPI: 1811105489
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1811105489 | ||||||||||||
| Enumeration Date | 2007-05-18 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 2105 SAWMILL CREEK RD SITKA, AK 99835-9711 United States Phone: 907-747-7437 | Fax:907-747-7437 | ||||||||||||
| Primary Practice Address | 222 TONGASS DR SITKA, AK 99835-9416 United States Phone: 907-966-8728 | Fax:907-966-8723 | ||||||||||||
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