| NPI | 1710347349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA ESCOBAR Owner 907-978-5733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: AK 1032552) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2024-04-26 |