Healthcare Provider Details

I. General information

NPI: 1346433844
Provider Name (Legal Business Name): MELISSA ANN SUNDBERG PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2007
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5660 B ST STE 200
ANCHORAGE AK
99518-1641
US

IV. Provider business mailing address

1917 ABBOTT RD STE 200
ANCHORAGE AK
99507-3448
US

V. Phone/Fax

Practice location:
  • Phone: 907-215-3045
  • Fax: 907-802-4538
Mailing address:
  • Phone: 907-279-4266
  • Fax: 907-743-8283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1340
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number1340
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: