| NPI | 1215572029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA CARTER Director Of Billing 907-341-9751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2025-01-02 |