Provider Demographics
NPI:1346705282
Name:ELLINGHAM, MCKENZIE FRANCES (DC)
Entity Type:Individual
Prefix:DR
First Name:MCKENZIE
Middle Name:FRANCES
Last Name:ELLINGHAM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3149 AMBERGATE DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-3865
Mailing Address - Country:US
Mailing Address - Phone:585-766-8919
Mailing Address - Fax:
Practice Address - Street 1:3149 AMBERGATE DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-3865
Practice Address - Country:US
Practice Address - Phone:585-766-8919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK127361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor