Provider Demographics
NPI:1760653471
Name:BILAN CHIROPRACTIC PC
Entity Type:Organization
Organization Name:BILAN CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:BILAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-569-1123
Mailing Address - Street 1:400 W NORTHERN LIGHTS BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3877
Mailing Address - Country:US
Mailing Address - Phone:907-569-1123
Mailing Address - Fax:
Practice Address - Street 1:400 W NORTHERN LIGHTS BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3877
Practice Address - Country:US
Practice Address - Phone:907-569-1123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK275249111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK160385Medicare PIN