Provider Demographics
NPI:1821577032
Name:SUNDOG WELLNESS LLC
Entity Type:Organization
Organization Name:SUNDOG WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HULBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:907-339-0330
Mailing Address - Street 1:3341 FAIRBANKS ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4145
Mailing Address - Country:US
Mailing Address - Phone:907-339-0330
Mailing Address - Fax:907-339-0331
Practice Address - Street 1:3341 FAIRBANKS ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4145
Practice Address - Country:US
Practice Address - Phone:907-433-9629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-08
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKCHIC523111N00000X
AKACUA126171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty