Bountiful

NPI #1114736899 in Ketchikan, Alaska

Provider Information

NPI Number: 1114736899
Entity Type: Organization
Organization Name: Bountiful
Primary Specialty: Meals
Enumeration Date: Jan 6, 2025
Last Updated: Jan 6, 2025

Practice Location

Address: 25 JEFFERSON WAY STE 102
City: Ketchikan
State: Alaska
ZIP Code: 99901-5953
Phone: (201) 259-0289

Authorized Official

Name: DR. KEVIN ARTHUR HALL, MD
Title: OWNER
Phone: (201) 259-0289

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Meals	174200000X	Primary

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