Healthcare Provider Details

I. General information

NPI: 1013047117
Provider Name (Legal Business Name): ARCTIC CHIROPRACTIC WEST MAT-SU, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MILE 51 GEORGE PARKS HWY #2
BIG LAKE AK
99652
US

IV. Provider business mailing address

1150 S COLONY WAY SUITE 3 PMB 226
PALMER AK
99645-6900
US

V. Phone/Fax

Practice location:
  • Phone: 907-892-7246
  • Fax:
Mailing address:
  • Phone: 907-250-7246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number429
License Number StateAK

VIII. Authorized Official

Name: DR. WALTER L CAMPBELL
Title or Position: OWNER
Credential: DC
Phone: 907-250-7246