NPI 1114269313

Odland Family Practice Clinic, LLC

Organisation Family Medicine Physician Wasilla, AK

Practice location

Address: 950 E Bogard Rd Suite 234, Wasilla, AK 99654-7184
Phone: (907) 355-0850
Fax: (907) 373-0117
Mailing address: 950 E Bogard Rd Suite 234, Wasilla, AK 99687-9481

Authorised official

Name: Shannon Pendergrass
Title: Billing Manager
Phone: (907) 355-0850

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 955730 (AK)

Other Family Medicine providers in Alaska →

Registry record

NPI: 1114269313
Entity type: Organization
NPI issued: 26 Mar 2013
Record last updated: 26 Mar 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.