| NPI | 1811521552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY STACK Office Manager 907-452-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 175F00000X Naturopath |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2020-03-02 |