| NPI | 1912202896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC W. COULTER President 907-569-1551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AK 4540) |
| Additional Taxonomies | 261QS0132X Clinic/Center, Ophthalmologic Surgery (Licence: AK 4540) |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2012-10-26 |