| NPI | 1558500694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYELLEN AROVOLD Advanced Nurse Practioner 907-586-1542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AK 17) |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2009-02-12 |