| NPI | 1497781678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALMADGE LAYNE CROWE Owner/Provider 907-248-8561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AK 242636) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2022-10-18 |