Healthcare Provider Details

I. General information

NPI: 1043000243
Provider Name (Legal Business Name): GENTLE ROOTS CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4210 MOUNTAIN VIEW DR STE 400
ANCHORAGE AK
99508-1509
US

IV. Provider business mailing address

4210 MOUNTAIN VIEW DR STE 400
ANCHORAGE AK
99508-1509
US

V. Phone/Fax

Practice location:
  • Phone: 678-357-9653
  • Fax: 907-217-1022
Mailing address:
  • Phone: 907-217-1002
  • Fax: 907-217-1022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. AIMEE BURGESS
Title or Position: MANAGER
Credential: DC
Phone: 907-217-1002