| NPI | 1407907561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN LINDGREN CHACON Billing Specialist 907-644-9407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: AK 708007) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |