Provider Demographics
NPI:1336441989
Name:ALPINE ANIMAL HOSPITAL PC
Entity Type:Organization
Organization Name:ALPINE ANIMAL HOSPITAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:C
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:541-752-7747
Mailing Address - Street 1:5120 NW HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-9128
Mailing Address - Country:US
Mailing Address - Phone:541-752-7747
Mailing Address - Fax:541-752-7749
Practice Address - Street 1:5120 NW HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-9128
Practice Address - Country:US
Practice Address - Phone:541-752-7747
Practice Address - Fax:541-752-7749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR088423-12174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174M00000XOther Service ProvidersVeterinarianGroup - Single Specialty