| NPI | 1710352281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN JAMES PETERSEN Owner 907-852-3099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK NP 106041) |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2015-12-09 |