| NPI | 1851573331 |
|---|---|
| Doing Business As | LAKE OTIS MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | DEBORAH L MACLEAN Office Mgr 907-341-7757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 905735) |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2007-11-27 |