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General NPI Number Information
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NPI Number | 1124136023
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Entity Type | Organization
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Legal Business Name | ALASKAN PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 09/09/2010
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Provider Practice Location Address
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Address Line | 36275 KENAI SPUR HWY SUITE 5
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City | SOLDOTNA
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State | AK
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Zip | 99669-7106
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Country | US
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Telephone | 907-260-2679
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Fax | 907-260-2676
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Provider Business Mailing Address
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Address Line | 36275 KENAI SPUR HWY SUITE 5
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City | SOLDOTNA
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State | AK
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Zip | 99669-7106
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Country | US
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Telephone | 907-260-2679
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Fax | 907-260-2676
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Authorized Official
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Title or Position | PHYSICAL THERAPIST-OWNER/ADMINISTRA
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Name | JILL SKIDMORE-ERICKSON
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Credential | PT
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Telephone | 907-260-2679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 229
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License Number State | AK
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