| NPI | 1861839250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EYDIE YVONNE FLYGARE Owner 907-563-0555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AK 2933) |
| Enumeration Date | 2013-05-27 |
| Last Update Date | 2013-05-27 |