NPI | 1235371360 |
---|---|
Entity Type | Organization |
Authorized Contact | DONALD IVES Manager 907-452-8346 |
Organization Subpart ? | No |
Primary Taxonomy | 202K00000X |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2009-04-06 |
Last Update Date | 2009-04-06 |