Healthcare Provider Details
I. General information
NPI: 1821572553
Provider Name (Legal Business Name): CHRISTY O'BRIEN PTA, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/19/2018
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1200 AIRPORT HEIGHTS RD, SUITE 240
ANCHORAGE AK
99508
US
IV. Provider business mailing address
PO BOX 211496
ANCHORAGE AK
99521-1496
US
V. Phone/Fax
- Phone: 530-919-1045
- Fax: 907-313-1369
- Phone: 530-919-1045
- Fax: 907-313-1369
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225200000X |
| Taxonomy | Physical Therapy Assistant |
| License Number | 249615 |
| License Number State | AK |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | 115498 |
| License Number State | AK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: