Healthcare Provider Details

I. General information

NPI: 1730004961
Provider Name (Legal Business Name): SUSITNA PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16932 E SUNSHINE RD
TALKEETNA AK
99676-1335
US

IV. Provider business mailing address

PO BOX 486
TALKEETNA AK
99676-0486
US

V. Phone/Fax

Practice location:
  • Phone: 573-795-9944
  • Fax:
Mailing address:
  • Phone: 573-795-9944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JONI ELIZABETH KARR
Title or Position: MANAGER
Credential:
Phone: 573-795-9944