Provider Demographics
NPI:1245570431
Name:ARCTIC CHIROPRACTIC SOLDOTNA LLC
Entity Type:Organization
Organization Name:ARCTIC CHIROPRACTIC SOLDOTNA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER / ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-244-3268
Mailing Address - Street 1:4000 W DIMOND BLVD
Mailing Address - Street 2:STE #4
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-1401
Mailing Address - Country:US
Mailing Address - Phone:907-420-4949
Mailing Address - Fax:907-420-4950
Practice Address - Street 1:35060 KENAI SPUR HWY
Practice Address - Street 2:STE #1
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7620
Practice Address - Country:US
Practice Address - Phone:907-420-4949
Practice Address - Fax:907-420-4950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty