| NPI | 1699309427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ROURICK Compliance Officer 907-277-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 111N00000X Chiropractor | |
| 207LP2900X Anesthesiology, Pain Medicine | |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2020-03-02 |