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General NPI Number Information
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NPI Number | 1639440423
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Entity Type | Organization
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Legal Business Name | ARCTIC CHIROPRACTIC
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Dates
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Enumeration Date | 01/25/2012
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Last Update Date | 01/25/2012
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Provider Practice Location Address
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Address Line | 113 E FRONT ST STE 102
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City | NOME
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State | AK
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Zip | 99762-7477
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Country | US
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Telephone | 907-443-7477
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Fax |
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Provider Business Mailing Address
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Address Line | 1150 S COLONY WAY STE 3 PMB 226
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City | PALMER
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State | AK
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Zip | 99645
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Country | US
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Telephone | 907-892-7246
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LORI STONE
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Credential |
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Telephone | 907-892-7246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 429
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License Number State | AK
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