| NPI | 1083159164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY HENRY ILIFF Owner 907-406-0834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: AK 116862) |
| Enumeration Date | 2016-12-28 |
| Last Update Date | 2016-12-28 |