| NPI | 1124667498 |
|---|---|
| Doing Business As | INDEPENDENCE HEALTHCARE PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | HENRY G KRULL Md/Owner 907-262-6454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2020-02-25 |