Provider Demographics
NPI:1689844151
Name:DISCOVERY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:DISCOVERY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:MACONACHIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-222-6121
Mailing Address - Street 1:3565 ARCTIC BLVD
Mailing Address - Street 2:SUITE D5
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4567
Mailing Address - Country:US
Mailing Address - Phone:907-562-2273
Mailing Address - Fax:907-562-2263
Practice Address - Street 1:3565 ARCTIC BLVD
Practice Address - Street 2:SUITE D5
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4567
Practice Address - Country:US
Practice Address - Phone:907-562-2273
Practice Address - Fax:907-562-2263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK465111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty