Provider Demographics
NPI:1073007209
Name:CENTER FOR NATURAL MEDICINE, INC.
Entity Type:Organization
Organization Name:CENTER FOR NATURAL MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:ND, LAC
Authorized Official - Phone:907-694-5522
Mailing Address - Street 1:16844 EASY ST
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7814
Mailing Address - Country:US
Mailing Address - Phone:907-694-5522
Mailing Address - Fax:907-694-5522
Practice Address - Street 1:16844 EASY ST
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577
Practice Address - Country:US
Practice Address - Phone:907-694-5522
Practice Address - Fax:907-694-5522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK33171100000X
AK175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty