Provider Demographics
NPI:1215983259
Name:WHITE SPRUCE MEDICAL INC
Entity type:Organization
Organization Name:WHITE SPRUCE MEDICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:LUPER
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:907-452-3600
Mailing Address - Street 1:104 KUTTER RD
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-3169
Mailing Address - Country:US
Mailing Address - Phone:907-452-3600
Mailing Address - Fax:907-452-3695
Practice Address - Street 1:1275 SADLER WAY STE 104
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-3175
Practice Address - Country:US
Practice Address - Phone:907-452-3600
Practice Address - Fax:907-452-3695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty