Healthcare Provider Details

I. General information

NPI: 1497668388
Provider Name (Legal Business Name): EQUINOX PHYSICAL THERAPY & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2373 SELIEF LN
KODIAK AK
99615-6926
US

IV. Provider business mailing address

PO BOX 1944
KODIAK AK
99615-1944
US

V. Phone/Fax

Practice location:
  • Phone: 907-942-4818
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: RACHEL LATHAM
Title or Position: OWNER
Credential: DPT
Phone: 907-942-4818