Organization
GRAYLING MEDICAL GROUP LLC
Active
Other names
Kenai Spine
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE M ERB BSN,RN (PRACTICE ADMINISTRATOR)
(907) 714-3117
Entity
Organization
Contact information
Practice address
240 HOSPITAL PLACE, SUITE 103, SOLDOTNA, AK 99669
(907) 260-5455
(877) 200-7122
Mailing address
PO BOX 2509, SOLDOTNA, AK 99669
(907) 260-5455
(877) 200-7122
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
6826
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1580702
—
AK
05
—
MD9678
—
AK
Enumeration date
08/14/2012
Last updated
11/30/2021
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