Provider Demographics
NPI:1558609073
Name:NCC INC
Entity Type:Organization
Organization Name:NCC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LUTHER
Authorized Official - Last Name:EMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-457-5100
Mailing Address - Street 1:3677 COLLEGE RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709
Mailing Address - Country:US
Mailing Address - Phone:907-457-5100
Mailing Address - Fax:
Practice Address - Street 1:3677 COLLEGE RD
Practice Address - Street 2:SUITE 10
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-3712
Practice Address - Country:US
Practice Address - Phone:907-457-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK980994111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty