| NPI | 1780054031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE PAUL NELSON Owner 907-441-6310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: AK 101388) |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2015-09-30 |