Provider Demographics
NPI:1811167331
Name:CHERRIE CHIROPRACTIC
Entity type:Organization
Organization Name:CHERRIE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-561-4421
Mailing Address - Street 1:700 W NORTHERN LIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3874
Mailing Address - Country:US
Mailing Address - Phone:907-561-4421
Mailing Address - Fax:907-561-5257
Practice Address - Street 1:700 W NORTHERN LIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3874
Practice Address - Country:US
Practice Address - Phone:907-561-4421
Practice Address - Fax:907-561-5257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK314111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKK153124OtherMEDICARE GROUP NUMBER
AKK153124OtherMEDICARE GROUP NUMBER
AKK153126Medicare PIN