| NPI | 1447640560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD CORRAL Administrator 907-903-9552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: AK 100943) |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2015-01-27 |