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General NPI Number Information
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NPI Number | 1386508430
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Entity Type | Individual
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Provider Name | JENNIFER MOCK
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Gender | Female
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 4800 CORDOVA ST
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City | ANCHORAGE
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State | AK
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Zip | 99503-7218
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Country | US
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Telephone | 907-561-3333
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Fax |
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Provider Business Mailing Address
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Address Line | 10313 THUJA CIR
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City | ANCHORAGE
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State | AK
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Zip | 99507-4127
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Country | US
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Telephone | 907-351-1673
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PHYP1161
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License Number State | AK
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