Provider Demographics
NPI:1952706780
Name:SPINE AND JOINT REHABILITATION ASSOCIATES OF ALASKA INC
Entity type:Organization
Organization Name:SPINE AND JOINT REHABILITATION ASSOCIATES OF ALASKA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:VANALSTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-230-4645
Mailing Address - Street 1:4007 OLD SEWARD HIGHWAY STE 700
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503
Mailing Address - Country:US
Mailing Address - Phone:907-230-4645
Mailing Address - Fax:
Practice Address - Street 1:4007 OLD SEWARD HIGHWAY STE 1000
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-230-4645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKCHR542111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty