OrganizationActive
Integrated Care, LLC
NPI 1104154913 · General Practice Physician · Wasilla, AK
Provider details
- NPI number
- 1104154913
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Michael Underwood, Agent
- License
- 380 (AK)
Practice location
540 E Hjellen Drive
Wasilla, AK 99654
Phone: (907) 696-1654
Fax: (907) 696-3654
Mailing address
Po Box 773313
Eagle River, AK 99577-3313
Registry dates
- Enumerated
- 2009-12-07
- Last updated
- 2009-12-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.