Healthcare Provider Details

I. General information

NPI: 1639238694
Provider Name (Legal Business Name): NORTH POLE PHYSICAL THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 04/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 LEWIS ST
NORTH POLE AK
99705-7699
US

IV. Provider business mailing address

157 LEWIS ST
NORTH POLE AK
99705-7699
US

V. Phone/Fax

Practice location:
  • Phone: 907-488-4978
  • Fax: 907-488-4976
Mailing address:
  • Phone: 907-488-4978
  • Fax: 907-488-4976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ALEC KAY
Title or Position: OWNER/PHYSICAL THERAPY
Credential:
Phone: 907-488-4978