| NPI | 1568633279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH RAYMOND PERVIER Owner 907-276-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AK 2064) |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2008-04-02 |