| NPI | 1649534843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN THOMAS GRISSOM President 907-631-3578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AK 976033) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2018-05-16 |