Provider Demographics
NPI:1508933300
Name:EXCELLENCE IN HEALTH CHIROPRACTIC AND REHABILITATION CLINIC PC
Entity Type:Organization
Organization Name:EXCELLENCE IN HEALTH CHIROPRACTIC AND REHABILITATION CLINIC PC
Other - Org Name:DR WILLIAM A ROSS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRINCIPAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-562-6325
Mailing Address - Street 1:810 E 36TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503
Mailing Address - Country:US
Mailing Address - Phone:907-562-6325
Mailing Address - Fax:907-569-5078
Practice Address - Street 1:810 E 36TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-562-6325
Practice Address - Fax:907-569-5078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK344111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCH03441Medicaid
AKCH03441Medicaid
U75838Medicare UPIN