Provider Demographics
NPI:1497959431
Name:ALASKA ADVANCED CARE CHIROPRACTIC
Entity Type:Organization
Organization Name:ALASKA ADVANCED CARE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:PYHALA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-262-6050
Mailing Address - Street 1:35561B KENAI SPUR HWY
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7625
Mailing Address - Country:US
Mailing Address - Phone:907-262-6050
Mailing Address - Fax:907-262-7470
Practice Address - Street 1:35561B KENAI SPUR HWY
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7625
Practice Address - Country:US
Practice Address - Phone:907-262-6050
Practice Address - Fax:907-262-7470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty