MEDICARE: BROOKE ERIN BIALOBLOCKI OTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	257384	AK

General Provider Information

NPI Number	:	1710804430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE ERIN BIALOBLOCKI OTD

Provider Business Mailing Address
First Line	:	PO BOX 672075
Second Line	:
City	:	CHUGIAK
State	:	AK
Zip	:	99567-2075
Country	:	US
Telephone Number	:	907-921-7384
Fax Number	:	844-605-1820

Provider Business Practice Location Address
First Line	:	12032 BUSINESS BLVD STE A
Second Line	:
City	:	EAGLE RIVER
State	:	AK
Zip	:	99577-7725
Country	:	US
Telephone Number	:	907-921-7384
Fax Number	:	844-605-1820

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2026
Last Update Date	:	07/02/2026

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