| NPI | 1720603095 |
|---|---|
| Doing Business As | TRIBAL- KKGB CFDS |
| Entity Type | Organization |
| Authorized Contact | RONALD LEE OLSON Executive Vice President Finance 907-729-4939 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2023-09-14 |