| NPI | 1750880654 |
|---|---|
| Doing Business As | EAGLE RIVER DERMATOLOGY INC |
| Entity Type | Organization |
| Authorized Contact | LINDSAY JAY PROCTOR Office Manager 907-694-3303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AK AK503) |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-02-06 |