| NPI | 1164669040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD LEE OLSON VP Finance 907-729-4939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AK 20467) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AK 20467) |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2016-01-28 |