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NPI Code Detail

MEDICARE: LUTHER CHIROPRACTIC CENTER

MEDICARE: LUTHER CHIROPRACTIC CENTER
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
1302F00000XExclusive Provider Organization102210AK

General Provider Information

NPI Number : 1639529399
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUTHER CHIROPRACTIC CENTER
Provider Business Mailing Address
First Line : 1130 W DIMOND BLVD STE D
Second Line :
City : ANCHORAGE
State : AK
Zip : 99515-1511
Country : US
Telephone Number : 907-868-1517
Fax Number :
Provider Business Practice Location Address
First Line : 1130 W DIMOND BLVD STE D
Second Line :
City : ANCHORAGE
State : AK
Zip : 99515-1511
Country : US
Telephone Number : 907-868-1517
Fax Number :
Authorized Official
Title or Position : MASSAGE THERAPIST
Name : MISS JENNIFER LA GINA HIGHFIELD
Credential : LMT
Telephone Number : 907-868-1517
Provider Enumeration Date : 06/14/2016
Last Update Date : 06/14/2016

Similar Medicare Providers

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Practice Location Address:
1130 W DIMOND BLVD STE D
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Directions to “LUTHER CHIROPRACTIC CENTER ” Practice Location

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