| NPI | 1720148976 |
|---|---|
| Other Name | NEW STUYAHOK CLINIC |
| Entity Type | Organization |
| Authorized Contact | CATHY LEEANN TAYLOR Provider Enrollment Specialist 907-842-5201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2023-10-06 |