| NPI | 1932159076 |
|---|---|
| Doing Business As | BSD-FIREWEED |
| Entity Type | Organization |
| Authorized Contact | RONALD LEE OLSON Executive Vice President Finance 907-729-4939 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2024-04-19 |