| NPI | 1164769204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODERIC SMITH President 907-562-6310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: AK 4904) |
| Enumeration Date | 2013-01-09 |
| Last Update Date | 2013-01-09 |