MEDICARE: DR. DONALD JOHN BLOMMER JR. D.C.

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	111N00000X	Chiropractor	346	AK

General Provider Information

NPI Number	:	1538280136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD JOHN BLOMMER JR. D.C.

Provider Business Mailing Address
First Line	:	3120 DENALI STREET, SUITE 8
Second Line	:	SUITE 8
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-3957
Country	:	US
Telephone Number	:	907-277-7757
Fax Number	:	907-562-7733

Provider Business Practice Location Address
First Line	:	3120 DENALI STREET, SUITE 8
Second Line	:	SUITE 8
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-3957
Country	:	US
Telephone Number	:	907-277-7757
Fax Number	:	907-562-7733

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	07/08/2007

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