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General NPI Number Information
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NPI Number | 1114800562
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Entity Type | Organization
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Legal Business Name | KJT, LLC
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 1314 SHUROS DR
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City | FAIRBANKS
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State | AK
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Zip | 99709-6740
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Country | US
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Telephone | 307-267-6150
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Fax | 833-986-3605
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Provider Business Mailing Address
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Address Line | 560 GRANITE PEAK DR APT 102
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City | CASPER
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State | WY
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Zip | 82609-4522
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Country | US
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Telephone | 307-267-6150
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Fax | 833-986-3605
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Authorized Official
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Title or Position | OWNER
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Name | KATI JO TUMA
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Credential | MMS, PA-C
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Telephone | 307-267-6150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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