| NPI | 1639802390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE MCDONALD AO/Owner 907-826-5753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2022-07-08 |
| Last Update Date | 2022-07-12 |