| NPI | 1376916833 |
|---|---|
| Other Name | NA |
| Entity Type | Organization |
| Authorized Contact | JOHN DOUGLAS ZIPPERER Member/Manager 907-707-9206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2015-11-05 |