| NPI | 1194849307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND E. BEARD Practice Administrator 907-677-7440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 225100000X Physical Therapist | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |