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General NPI Number Information
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NPI Number | 1558609073
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Entity Type | Organization
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Legal Business Name | NCC INC
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Dates
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Enumeration Date | 01/17/2013
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 3677 COLLEGE RD SUITE 10
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City | FAIRBANKS
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State | AK
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Zip | 99709-3712
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Country | US
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Telephone | 907-457-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 3677 COLLEGE RD SUITE 10
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City | FAIRBANKS
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State | AK
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Zip | 99709
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Country | US
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Telephone | 907-457-5100
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM LUTHER EMERSON
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Credential | DC
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Telephone | 907-457-5100
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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 | 980994
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License Number State | AK
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