Cottonwood Creek Clinic Llc

NPI 1134523855 - Internal Medicine - 207R00000X

NPI Details
NPI 1134523855
Enumeration Date 10/09/2014
Last Updated 02/18/2015
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name RICHARD RICHARD
Position OWNER
Phone (907) 373-5950
Fax (907) 373-5954
Practice Location
1751 E GARDNER WAY
SUITE D
WASILLA AK, 99654-6564, US
Phone (907) 373-5950
Fax (907) 373-5954
Business Location
1751 E GARDNER WAY
SUITE D
WASILLA AK, 99654-6564, US
Phone (907) 373-5950
Fax (907) 373-5954
Toxanomy
Taxonomy Code 207R00000X
License State Alaska
License Number 1011473
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According to our database, Cottonwood Creek Clinic Llc NPI is 1134523855, taxonomy code is 207R00000X and license number is 1011473, license state is located at Alaska. Cottonwood Creek Clinic Llc physically located at 1751 E Gardner Way, Wasilla AK, 99654-6564. NPI Number 1033115704 has the healthcare provider type.

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1134523855 NPI number is provided on an as is basis without warranty of any kind. 1134523855 is maintained by the National Plan & Provider Enumeration System. The contents of Cottonwood Creek Clinic Llc are for informational purposes only.