Provider Demographics
NPI:1891824595
Name:CAMPBELL, WALTER L (DC)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:L
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 S COLONY WAY
Mailing Address - Street 2:SUITE 3 PMB 226
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-6900
Mailing Address - Country:US
Mailing Address - Phone:907-250-7246
Mailing Address - Fax:
Practice Address - Street 1:6921 BRAYTON DR
Practice Address - Street 2:SUITE 204
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-2488
Practice Address - Country:US
Practice Address - Phone:907-929-1760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK429111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor