| NPI | 1972894418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM E THIELE Executive Officer 907-242-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AK 4125) |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2011-05-02 |