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General NPI Number Information
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NPI Number | 1891857165
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Entity Type | Individual
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Provider Name | MANDI ELAINE EHLERS MSPT
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Gender | Female
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 10/04/2010
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Provider Practice Location Address
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Address Line | 108 E CORRAL AVE
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City | SOLDOTNA
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State | AK
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Zip | 99669-7524
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Country | US
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Telephone | 907-260-5893
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Fax |
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Provider Business Mailing Address
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Address Line | 411 HALLER ST
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City | KENAI
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State | AK
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Zip | 99611-7440
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Country | US
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Telephone | 907-444-0682
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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 | 1734
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License Number State | AK
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