| NPI | 1790894806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA J. GOERANSSON Administrator 907-585-5951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: AK PT0169) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |