Wild Iris LLC

NPI #1003244211 in Wasilla, Alaska

Provider Information

NPI Number: 1003244211
Entity Type: Organization
Organization Name: Wild Iris LLC
Primary Specialty: Family Medicine
Enumeration Date: Oct 25, 2013
Last Updated: Oct 20, 2014

Practice Location

Address: 851 E WESTPOINT DR
Address 2: SUITE 207
City: Wasilla
State: Alaska
ZIP Code: 99654-7183
Phone: (907) 373-9463

Authorized Official

Name: DR. LISA HARRISON, M.D.
Title: OWNER/PHYSICIAN
Phone: (907) 373-9463

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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