Organization
SPORTS & SPINAL INJURY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW K HUETTL D.C. (CHIROPRACTOR)
(907) 522-3511
Entity
Organization
Contact information
Practice address
6634 LAKE OTIS PKWY, A, ANCHORAGE, AK 99507-2176
(907) 522-3511
(907) 522-8551
Mailing address
6634 LAKE OTIS PKWY, A, ANCHORAGE, AK 99507-2176
(907) 522-3511
(907) 522-8551
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CH0328
—
AK
Enumeration date
09/24/2007
Last updated
09/16/2010
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