| NPI | 1285677054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVIEVE BASSLER Credentialing 907-563-3145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AK 433722) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AK 433722) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2022-06-06 |