Provider Demographics
NPI:1376778852
Name:AURORA CHIROPRACTIC CENTER P.C.
Entity Type:Organization
Organization Name:AURORA CHIROPRACTIC CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:MESSERSCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:CHIROPRACTIC ORTHOPE
Authorized Official - Phone:907-789-1344
Mailing Address - Street 1:9309 GLACIER HWY
Mailing Address - Street 2:STE B106
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801
Mailing Address - Country:US
Mailing Address - Phone:907-789-1344
Mailing Address - Fax:907-789-6134
Practice Address - Street 1:9309 GLACIER HWY
Practice Address - Street 2:STE B106
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801
Practice Address - Country:US
Practice Address - Phone:907-789-1344
Practice Address - Fax:907-789-6134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-27
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK150111N00000X
AK511111N00000X
AK312111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKK162573OtherMEDICARE PTAN