| NPI | 1861450629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE I DODGE-PAMPLIN Executive Director 907-929-2567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AK 435487) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2020-08-22 |