| NPI | 1609515048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN RENEE BLOMKER Director Of Revenue Cycle 907-357-9590 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine Rheumatology |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2022-06-02 |