Provider Demographics
NPI:1669423927
Name:CONKLIN, AMY CYNOWA (DC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:CYNOWA
Last Name:CONKLIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 DENALI ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4038
Mailing Address - Country:US
Mailing Address - Phone:907-563-7662
Mailing Address - Fax:907-562-7662
Practice Address - Street 1:3333 DENALI ST
Practice Address - Street 2:SUITE 150
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4038
Practice Address - Country:US
Practice Address - Phone:907-563-7662
Practice Address - Fax:907-562-7662
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK393111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor