Provider Demographics
NPI:1841479912
Name:MCKINNON, ANNIE ELIZABETH (DC)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:ELIZABETH
Last Name:MCKINNON
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 1:6613 BRAYTON DR STE B
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-2153
Mailing Address - Country:US
Mailing Address - Phone:907-677-6345
Mailing Address - Fax:907-677-6604
Practice Address - Street 1:6613 BRAYTON DR STE B
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-2153
Practice Address - Country:US
Practice Address - Phone:907-677-6345
Practice Address - Fax:907-677-6604
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK463111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor