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General NPI Number Information
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NPI Number | 1245570431
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Entity Type | Organization
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Legal Business Name | ARCTIC CHIROPRACTIC SOLDOTNA LLC
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Dates
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Enumeration Date | 02/25/2013
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Last Update Date | 02/25/2013
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Provider Practice Location Address
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Address Line | 35060 KENAI SPUR HWY STE #1
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City | SOLDOTNA
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State | AK
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Zip | 99669-7620
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Country | US
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Telephone | 907-420-4949
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Fax | 907-420-4950
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Provider Business Mailing Address
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Address Line | 4000 W DIMOND BLVD STE #4
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City | ANCHORAGE
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State | AK
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Zip | 99502-1401
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Country | US
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Telephone | 907-420-4949
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Fax | 907-420-4950
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Authorized Official
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Title or Position | MEMBER / ORGANIZER
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Name | EDWARD FOSTER
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Credential | DC
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Telephone | 907-244-3268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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