Provider Demographics
NPI:1538153580
Name:MINOR, MARY A (ND)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:A
Last Name:MINOR
Suffix:
Gender:F
Credentials:ND
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Mailing Address - Street 1:1221 NOBLE ST
Mailing Address - Street 2:STE 101
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-4926
Mailing Address - Country:US
Mailing Address - Phone:907-456-6279
Mailing Address - Fax:907-456-6263
Practice Address - Street 1:1221 NOBLE ST
Practice Address - Street 2:STE 101
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4926
Practice Address - Country:US
Practice Address - Phone:907-456-6279
Practice Address - Fax:907-456-6263
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2010-05-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK12175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath