| NPI | 1053622175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD LEE OLSON VP Of Finance 907-729-4939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: AK 20467) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2016-02-04 |