| NPI | 1114566536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRIS KILE Management 907-885-4760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 2083S0010X Preventive Medicine Sports Medicine | |
| Enumeration Date | 2020-01-02 |
| Last Update Date | 2020-01-02 |