| NPI | 1609173798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL M CARROLL Office Manager 907-569-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AK 952570) |
| Enumeration Date | 2011-02-25 |
| Last Update Date | 2011-02-25 |