Provider Demographics
NPI:1316438724
Name:PUFFIN CHIROPRACTIC LLC
Entity type:Organization
Organization Name:PUFFIN CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:CHARESE
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-395-4466
Mailing Address - Street 1:403 OVERLAND AVE STE A
Mailing Address - Street 2:
Mailing Address - City:KENAI
Mailing Address - State:AK
Mailing Address - Zip Code:99611-8050
Mailing Address - Country:US
Mailing Address - Phone:907-395-4466
Mailing Address - Fax:907-395-4460
Practice Address - Street 1:403 OVERLAND AVE STE A
Practice Address - Street 2:
Practice Address - City:KENAI
Practice Address - State:AK
Practice Address - Zip Code:99611-8050
Practice Address - Country:US
Practice Address - Phone:907-395-4466
Practice Address - Fax:907-395-4460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK605111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK606OtherALASKA STATE LICENSE
AK605OtherALASKA STATE LICENSE