| NPI | 1073653424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CW JASPER Doctor 907-276-4611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2008-11-06 |