MEDICARE: MAX TREINEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172M00000X	Mechanotherapist		AK

General Provider Information

NPI Number	:	1285054395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAX TREINEN

Provider Business Mailing Address
First Line	:	1436 O ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99501-4963
Country	:	US
Telephone Number	:	907-301-4565
Fax Number	:

Provider Business Practice Location Address
First Line	:	1436 O ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99501-4963
Country	:	US
Telephone Number	:	907-301-4565
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2014
Last Update Date	:	04/16/2014

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Directions to “ MAX TREINEN ” Practice Location

Language	Start Address	Practice Location

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