Individual
DR. COREY M PAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
10004 GLACIER HWY, STE. B, JUNEAU, AK 99801-8560
(907) 790-2225
(907) 789-5577
Mailing address
10004 GLACIER HWY, STE. B, JUNEAU, AK 99801-8560
(907) 790-2225
(907) 789-5577
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHI 272
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00020015225
TAT
AK
01
—
92-0146428
FEDERAL TAX ID
—
05
—
CH0272
—
AK
Enumeration date
09/24/2006
Last updated
04/10/2012
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