Healthcare Provider Details

I. General information

NPI: 1386109239
Provider Name (Legal Business Name): DAVID FARMER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2019
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22502 SAMBAR LOOP
CHUGIAK AK
99567-5377
US

IV. Provider business mailing address

PO BOX 672075
CHUGIAK AK
99567-2075
US

V. Phone/Fax

Practice location:
  • Phone: 907-726-4663
  • Fax: 844-605-1820
Mailing address:
  • Phone: 907-726-4663
  • Fax: 844-605-1820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6103
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number149302
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: