Organization · NPI-2

Alaska Functional Medicine Clinic INC

Nurse Practitioner, Family · Anchorage, AK

NPI number1649705583
StatusActive
Last updated in NPPESApr 28, 2017

Details

NPI
1649705583
Entity type
Organization (NPI-2)
Legal business name
Alaska Functional Medicine Clinic INC
Organization subpart
No
Enumeration date
Apr 28, 2017
Last updated
Apr 28, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family––Yes

Practice location

9138 Arlon St
Suite A2
Anchorage, AK 99507-3876

Phone 907-375-9395 · Fax 907-375-9396

Mailing address

9138 Arlon St
Suite A2
Anchorage, AK 99507-3876

Phone 907-375-9395 · Fax 907-375-9396

Authorized official

Chris Bennett
Owner
9073759395

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