1992022107 NPI number — LUTHER CHIROPRACTIC CENTER, LLC.

Table of content: (NPI 1992022107)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992022107 NPI number — LUTHER CHIROPRACTIC CENTER, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LUTHER CHIROPRACTIC CENTER, LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992022107
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1130 W DIMOND BLVD STE D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANCHORAGE
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99515-1511
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-868-1517
Provider Business Mailing Address Fax Number:
907-868-9053

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1130 W DIMOND BLVD STE D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANCHORAGE
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99515-1511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-868-1517
Provider Business Practice Location Address Fax Number:
907-868-9053
Provider Enumeration Date:
04/27/2010

Additional Information

Authorized Official

Authorized Official Last Name:
LUTHER
Authorized Official First Name:
DOUGLAS
Authorized Official Middle Name:
BYRON
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
907-868-1517

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  419 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: 364 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com