| NPI | 1194152058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANI LAZELL DEAN President 907-250-1151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: AK 334) |
| Enumeration Date | 2013-10-08 |
| Last Update Date | 2015-05-14 |