| NPI | 1982059952 |
|---|---|
| Doing Business As | PETALOSO |
| Entity Type | Organization |
| Authorized Contact | JANICE L STABLES President 907-978-7721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AK 420) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2016-04-27 |