Provider Demographics
NPI:1962026021
Name:ARCTIC CHIROPRACTIC SEWARD
Entity Type:Organization
Organization Name:ARCTIC CHIROPRACTIC SEWARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-947-6319
Mailing Address - Street 1:11694 SEWARD HWY
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:AK
Mailing Address - Zip Code:99664-9710
Mailing Address - Country:US
Mailing Address - Phone:907-224-8680
Mailing Address - Fax:
Practice Address - Street 1:11694 SEWARD HWY
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:AK
Practice Address - Zip Code:99664-9710
Practice Address - Country:US
Practice Address - Phone:907-224-8680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK10132506OtherLICENSE NUMBER