| NPI | 1285410340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC NORDSTROM Medical Director 907-222-5052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Additional Taxonomies | 163W00000X Registered Nurse |
| Enumeration Date | 2023-09-05 |
| Last Update Date | 2025-07-25 |