| NPI | 1942323779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT ALLEN URSEL CEO Physician Assistant 907-224-8733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 202) |
| Enumeration Date | 2007-04-08 |
| Last Update Date | 2011-04-13 |