| NPI | 1568230456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANNA MAVIS CONSTANCE MOISII Physician Assistant/ Owner 907-921-2221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2024-05-23 |