| NPI | 1154591451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI BRANDT Owner 907-344-7722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: AK 911398) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2008-12-19 |