Provider Demographics
NPI:1952451304
Name:BALDRIDGE, DAVID LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEE
Last Name:BALDRIDGE
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:PO BOX 1783
Mailing Address - Street 2:
Mailing Address - City:KENAI
Mailing Address - State:AK
Mailing Address - Zip Code:99611-1783
Mailing Address - Country:US
Mailing Address - Phone:907-740-3969
Mailing Address - Fax:888-855-0607
Practice Address - Street 1:601 FRONTAGE RD STE 103
Practice Address - Street 2:
Practice Address - City:KENAI
Practice Address - State:AK
Practice Address - Zip Code:99611-7783
Practice Address - Country:US
Practice Address - Phone:907-740-3969
Practice Address - Fax:888-855-0607
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKCHIC607111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor