Provider Demographics
NPI:1982876033
Name:ALLEN, GEORGE (DC)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3677 COLLEGE RD
Mailing Address - Street 2:STE 10
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-3712
Mailing Address - Country:US
Mailing Address - Phone:907-457-5100
Mailing Address - Fax:907-457-5102
Practice Address - Street 1:3677 COLLEGE RD
Practice Address - Street 2:STE 10
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-3712
Practice Address - Country:US
Practice Address - Phone:907-457-5100
Practice Address - Fax:907-457-5102
Is Sole Proprietor?:No
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK204111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor