Provider Demographics
NPI:1871613901
Name:WEBB, GARY LEE (DC)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:LEE
Last Name:WEBB
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 C ST STE 110
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3979
Mailing Address - Country:US
Mailing Address - Phone:907-562-6181
Mailing Address - Fax:907-562-6034
Practice Address - Street 1:3150 C ST STE 110
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3979
Practice Address - Country:US
Practice Address - Phone:907-562-6181
Practice Address - Fax:907-562-6034
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK130111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCH0064Medicaid
AKCH0064Medicaid