Provider Demographics
NPI:1528127982
Name:J DIRK LAWYER DC INC
Entity type:Organization
Organization Name:J DIRK LAWYER DC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:DIRK
Authorized Official - Last Name:LAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-522-5050
Mailing Address - Street 1:8427 LAVIENTO DR STE 101
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-1951
Mailing Address - Country:US
Mailing Address - Phone:907-522-5050
Mailing Address - Fax:907-522-5040
Practice Address - Street 1:8427 LAVIENTO DR STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1951
Practice Address - Country:US
Practice Address - Phone:907-522-5050
Practice Address - Fax:907-522-5040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1528127982Medicare PIN
COC451288Medicare ID - Type Unspecified