| NPI | 1255528733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI L ELLIOTT Owner 907-335-0034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 4040) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AK 175) |
| 363A00000X Physician Assistant (Licence: AK 725) | |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2008-06-09 |