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General NPI Number Information
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NPI Number | 1447973219
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Entity Type | Organization
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Legal Business Name | ADVANTAGE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 44009 STERLING HWY STE B
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City | SOLDOTNA
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State | AK
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Zip | 99669-8030
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Country | US
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Telephone | 907-420-0585
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Fax |
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Provider Business Mailing Address
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Address Line | 44604 STERLING HWY STE D
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City | SOLDOTNA
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State | AK
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Zip | 99669-7962
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Country | US
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Telephone | 907-420-0585
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Fax | 907-420-0586
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Authorized Official
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Title or Position | OWNER
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Name | JEOFFREY LANFEAR
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Credential |
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Telephone | 907-420-0585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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