| NPI | 1326753021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN RENEE BLOMKER Director Of Revenue Cycle 907-864-4625 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-01-17 |
| Last Update Date | 2023-01-17 |