Provider Demographics
NPI:1477750776
Name:LAWYER, JON DIRK (DC)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:DIRK
Last Name:LAWYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8427 LAVIENTO DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515
Mailing Address - Country:US
Mailing Address - Phone:907-522-5050
Mailing Address - Fax:907-522-5040
Practice Address - Street 1:8427 LAVIENTO DR
Practice Address - Street 2:SUITE 101
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515
Practice Address - Country:US
Practice Address - Phone:907-522-5050
Practice Address - Fax:907-522-5040
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK495111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
079-26-6123AMedicare PIN
COC451288Medicare ID - Type UnspecifiedMEDICARE NUMBER