Provider Demographics
NPI:1437489903
Name:ARCTIC CHIROPRACTIC EAST MAT-SU LLC
Entity Type:Organization
Organization Name:ARCTIC CHIROPRACTIC EAST MAT-SU LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGELBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-746-7842
Mailing Address - Street 1:1150 S COLONY WAY
Mailing Address - Street 2:STE 3 PMB 221
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-6900
Mailing Address - Country:US
Mailing Address - Phone:907-746-7842
Mailing Address - Fax:
Practice Address - Street 1:1734 PROSPECT DR
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645
Practice Address - Country:US
Practice Address - Phone:907-746-7842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty