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