| NPI | 1225633449 |
|---|---|
| Doing Business As | IDENTITY HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | LYNN MURPHY Operations Director 907-929-4528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2022-03-11 |