Provider Demographics
NPI:1477969178
Name:ORTIZ, RIZALDY A (DC)
Entity Type:Individual
Prefix:
First Name:RIZALDY
Middle Name:A
Last Name:ORTIZ
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 1:2021 OXBOW CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-7314
Mailing Address - Country:US
Mailing Address - Phone:907-301-8355
Mailing Address - Fax:
Practice Address - Street 1:300 E DIMOND BLVD STE 10A
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1947
Practice Address - Country:US
Practice Address - Phone:907-222-4604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC3279111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor