Provider Demographics
NPI:1538280136
Name:BLOMMER, DONALD JOHN JR (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JOHN
Last Name:BLOMMER
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3120 DENALI STREET, SUITE 8
Mailing Address - Street 2:SUITE 8
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3957
Mailing Address - Country:US
Mailing Address - Phone:907-277-7757
Mailing Address - Fax:907-562-7733
Practice Address - Street 1:3120 DENALI STREET, SUITE 8
Practice Address - Street 2:SUITE 8
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3957
Practice Address - Country:US
Practice Address - Phone:907-277-7757
Practice Address - Fax:907-562-7733
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK346111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor