Healthcare Provider Details

I. General information

NPI: 1962689893
Provider Name (Legal Business Name): EMILY KATHERINE RHODES LPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2008
Last Update Date: 01/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11421 OLD GLENN HWY
EAGLE RIVER AK
99577-7729
US

IV. Provider business mailing address

11421 OLD GLENN HWY
EAGLE RIVER AK
99577-7729
US

V. Phone/Fax

Practice location:
  • Phone: 907-694-2273
  • Fax:
Mailing address:
  • Phone: 907-694-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number323
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: