Bore Tide Services, LLC

NPI #1831411826 in Chugiak, Alaska

Provider Information

NPI Number: 1831411826
Entity Type: Organization
Organization Name: Bore Tide Services, LLC
Primary Specialty: Physician Assistant
Enumeration Date: Feb 18, 2010
Last Updated: Feb 18, 2010

Practice Location

Address: 22742 OBERG RD
City: Chugiak
State: Alaska
ZIP Code: 99567-5495
Phone: (907) 854-8452

Authorized Official

Name: MR. DENNIS S SERIE
Title: PHYSICIAN ASSISTANT
Phone: (907) 677-2990

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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