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Individual

MR. BARRY MATTHISEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C

Contact information

Practice address
1000 E DIMOND BLVD STE 202, ANCHORAGE, AK 99515-2029
(907) 349-4212
(907) 344-3381
Mailing address
1000 E DIMOND BLVD STE 202, ANCHORAGE, AK 99515-2008
(907) 349-4212
(907) 344-3381

Taxonomy

Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
228
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
CH1228
AK
Enumeration date
05/18/2007
Last updated
05/03/2017
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