| NPI | 1457083958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY CHRISTENSEN Director 907-228-3075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2022-06-24 |
| Last Update Date | 2022-07-18 |