Organization
DIMOND MEDICAL CLINIC, LLC
Active
Other names
Lake Otis Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH L MACLEAN (OFFICE MGR)
(907) 341-7757
Entity
Organization
Contact information
Practice address
4001 LAKE OTIS PKWY, #100, ANCHORAGE, AK 99508-5211
(907) 561-7757
Mailing address
300 E DIMOND BLVD, #12, ANCHORAGE, AK 99515-1908
(907) 341-7757
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
905735
AK
Other
Enumeration date
11/27/2007
Last updated
11/27/2007
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