| NPI | 1417031618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY N SCHULZ Manager 907-247-3301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AK 306825) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |