| NPI | 1487040309 |
|---|---|
| Other Name | WADE ERICKSON MD |
| Entity Type | Organization |
| Authorized Contact | WADE ERICKSON Md 907-357-9590 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2015-04-07 |