| NPI | 1831727445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN JOHNSON Owner 907-830-0920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 111NS0005X Chiropractor Sports Physician |
| 163WW0000X Registered Nurse Wound Care | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2020-03-30 |