National Provider Identifier Database

FULL SPECTRUM HEALTH LLC
Multi-Specialty


Contact Information

FULL SPECTRUM HEALTH, LLC
307 E NORTHERN LIGHTS BLVD STE 201
ANCHORAGE, AK99503-2701
Phone: 907-229-9766
Fax: 888-974-0807
Website:
Specialty Taxonomy Code
* Multi-Specialty 261QM1300X

* Indicates primary specialty

NPI Profile & details for FULL SPECTRUM HEALTH, LLC

NPI Number 1407360977
Legal business name
LBN
FULL SPECTRUM HEALTH, LLC
Authorized official TRACEY WIESE - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 11/20/2017
Last updated 11/20/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • AK Medicaid: 1022312

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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