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General NPI Number Information
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NPI Number | 1497959431
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Entity Type | Organization
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Legal Business Name | ALASKA ADVANCED CARE CHIROPRACTIC
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 35561B KENAI SPUR HWY
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City | SOLDOTNA
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State | AK
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Zip | 99669-7625
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Country | US
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Telephone | 907-262-6050
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Fax | 907-262-7470
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Provider Business Mailing Address
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Address Line | 35561B KENAI SPUR HWY
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City | SOLDOTNA
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State | AK
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Zip | 99669-7625
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Country | US
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Telephone | 907-262-6050
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Fax | 907-262-7470
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Authorized Official
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Title or Position | MANAGER
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Name | MATTHEW ALLAN PYHALA
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Credential | DC
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Telephone | 907-262-6050
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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 | 376
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License Number State | AK
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