Provider Demographics
NPI:1558800607
Name:BOREALIS CHIROPRACTIC INC
Entity Type:Organization
Organization Name:BOREALIS CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HULING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-420-7790
Mailing Address - Street 1:35249 KENAI SPUR HWY STE C
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7673
Mailing Address - Country:US
Mailing Address - Phone:907-420-0836
Mailing Address - Fax:907-420-0837
Practice Address - Street 1:35249 KENAI SPUR HWY STE C
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7673
Practice Address - Country:US
Practice Address - Phone:907-420-0836
Practice Address - Fax:907-420-0837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK105714111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty