| NPI | 1699952358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER KATHLEEN SAADY Medical Office Manager 907-561-9444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: AK 2741) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2011-05-17 |