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Raymond Gilligan Jr
Prosthetic/Orthotic Supplier in Fairbanks, Alaska
NPI 1326506882

Raymond Gilligan Jr is a Prosthetic/Orthotic Supplier based in Fairbanks, AK. Raymond Gilligan Jr practices in Fairbanks, AK. The NPI Number for Raymond Gilligan Jr is 1326506882 and holds a License No. (Alaska).

The current practice location address for Raymond Gilligan Jr is 3517 Industrial Ave, Fairbanks, AK and can be reached out via phone at 907-455-9255 and via fax at 907-452-1789.

Location: 3517 Industrial Ave, Fairbanks, AK, 99701-7737
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1326506882
Provider Name
Raymond Gilligan Jr
Credential
Provider Entity Type
Organization
Address
3517 Industrial Ave, Fairbanks, AK, 99701-7737
Phone Number
907-455-9255
Fax Number
907-452-1789
Provider Enumeration Date
03/04/2019
Last Update Date
03/10/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
1110253 01 AK BUSINESS LICENCE
institution
Provider Business Practice Location Address Details
Address
3517 Industrial Ave
City
Fairbanks
State
Alaska
Zip
99701-7737
Phone Number
907-455-9255
Fax Number
907-452-1789
person
Provider Business Mailing Address Details
Address
3517 Industrial Ave
City
Fairbanks
State
Alaska
Zip
99701-7737
Phone Number
907-455-9255
Fax Number
907-452-1789
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Customized Equipment
Taxonomy
332BC3200X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
()
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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