Provider Demographics
NPI:1487847356
Name:ALPINE FAMILY CORPORATION
Entity Type:Organization
Organization Name:ALPINE FAMILY CORPORATION
Other - Org Name:ALPINE FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:STRASSER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:208-642-2344
Mailing Address - Street 1:540 S 16TH ST
Mailing Address - Street 2:SUITE 118
Mailing Address - City:PAYETTE
Mailing Address - State:ID
Mailing Address - Zip Code:83661-3356
Mailing Address - Country:US
Mailing Address - Phone:208-642-2344
Mailing Address - Fax:208-642-4060
Practice Address - Street 1:540 S 16TH ST
Practice Address - Street 2:SUITE 118
Practice Address - City:PAYETTE
Practice Address - State:ID
Practice Address - Zip Code:83661-3356
Practice Address - Country:US
Practice Address - Phone:208-642-2344
Practice Address - Fax:208-642-4060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1173111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1370038Medicare PIN