| NPI | 1447451737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIO A LANZA President 907-258-1258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AK 3753) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AK 3905) |
| 208D00000X General Practice (Licence: AK 4503) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2008-02-26 |