| NPI | 1285806737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA R. BONGLO Owner/President 907-272-1282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: AK 100659) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-03-25 |