Healthcare Provider Details

I. General information

NPI: 1639440423
Provider Name (Legal Business Name): ARCTIC CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2012
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 E FRONT ST STE 102
NOME AK
99762-7477
US

IV. Provider business mailing address

1150 S COLONY WAY STE 3 PMB 226
PALMER AK
99645
US

V. Phone/Fax

Practice location:
  • Phone: 907-443-7477
  • Fax:
Mailing address:
  • Phone: 907-892-7246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number429
License Number StateAK

VIII. Authorized Official

Name: LORI STONE
Title or Position: OFFICE MANAGER
Credential:
Phone: 907-892-7246