MEDICARE: ARCTIC CHIROPRACTIC AND PHYSICAL MEDICINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP3300X	Pain Clinic/Center	439	AK

General Provider Information

NPI Number	:	1336524651
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARCTIC CHIROPRACTIC AND PHYSICAL MEDICINE

Provider Business Mailing Address
First Line	:	1150 S COLONY WAY STE 3
Second Line	:	PMB 226
City	:	PALMER
State	:	AK
Zip	:	99645-6967
Country	:	US
Telephone Number	:	907-543-7600
Fax Number	:	907-543-0015

Provider Business Practice Location Address
First Line	:	107 A ALEX HATELY
Second Line	:
City	:	BETHEL
State	:	AK
Zip	:	99559-3466
Country	:	US
Telephone Number	:	907-543-7600
Fax Number	:

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	DR. CHRISTOPHER FRANCIS TWIFORD
Credential	:	DC
Telephone Number	:	907-543-7600

Provider Enumeration Date	:	07/28/2015
Last Update Date	:	07/28/2015

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