Organization
INDEPENDENCE HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERCY BERG (OFFICE MANAGER)
(907) 262-6454
Entity
Organization
Contact information
Practice address
291 N FIREWEED ST, SOLDOTNA, AK 99669-7540
(907) 262-6454
Mailing address
291 N FIREWEED ST, SOLDOTNA, AK 99669-7540
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
1049851
AK
208100000X
Physical Medicine & Rehabilitation Physician
1049851
AK
2085R0202X
Diagnostic Radiology Physician
1049851
AK
261QM1300X
Multi-Specialty Clinic/Center
Primary
1049851
AK
Other
Enumeration date
03/02/2017
Last updated
03/09/2017
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