| NPI | 1245471796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH EUGENE BEATY Billing Agent 907-770-2301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: AK 233806) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2009-04-23 |