| NPI | 1336807486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARISE CARLSON Managing Member 907-252-6357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-12-06 |
| Last Update Date | 2022-06-20 |