Provider Demographics
NPI:1689032203
Name:ALTITUDE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ALTITUDE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AUGUST
Authorized Official - Middle Name:H
Authorized Official - Last Name:MANELICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-745-5444
Mailing Address - Street 1:6921 E GARTH CIR STE B
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-5922
Mailing Address - Country:US
Mailing Address - Phone:907-745-5444
Mailing Address - Fax:907-745-3774
Practice Address - Street 1:6921 E GARTH CIR
Practice Address - Street 2:SUITE B
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-5922
Practice Address - Country:US
Practice Address - Phone:907-745-5444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1031171111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty