| NPI | 1811170210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VADETTE FOWLER Chief Financial Officer 907-743-7321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 91963) |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2022-04-18 |