| NPI | 1477961720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY MIGGINS Owner 907-250-9441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2015-04-14 |