MEDICARE: PLAYFUL LEARNING PEDIATRIC THERAPY, LLC

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	225XP0200X	Pediatric Occupational Therapist	2045	AK

General Provider Information

NPI Number	:	1407129745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLAYFUL LEARNING PEDIATRIC THERAPY, LLC

Provider Business Mailing Address
First Line	:	12110 BUSINESS BLVD STE A413
Second Line	:
City	:	EAGLE RIVER
State	:	AK
Zip	:	99577-7725
Country	:	US
Telephone Number	:	907-317-9349
Fax Number	:

Provider Business Practice Location Address
First Line	:	12812 OLD GLENN HWY STE A4
Second Line	:
City	:	EAGLE RIVER
State	:	AK
Zip	:	99577-7003
Country	:	US
Telephone Number	:	907-317-9349
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. TIFFANY JOHNSTON
Credential	:	OTR/L
Telephone Number	:	907-317-9349

Provider Enumeration Date	:	02/16/2012
Last Update Date	:	02/16/2012

Similar Medicare Providers

1679571640 — HEALTH WORKS FAMILY MED CLINIC INC.
Practice Location Address:

12812 OLD GLENN HWY
EAGLE RIVER, AK
99577-7003

Practice Phone: 907-622-9675
Practice Fax: 907-622-9676

1679772735 — HEALTH WORKS FAMILY MEDICAL CLINIC INC
Practice Location Address:

12812 OLD GLENN HWY STE A7
EAGLE RIVER, AK
99577-7003

Practice Phone: 907-622-9675
Practice Fax:

1487893863 — TIFFANY G ADKINS
Practice Location Address:

12812 OLD GLENN HWY STE A3
EAGLE RIVER, AK
99577-7003

Practice Phone: 907-317-9349
Practice Fax:

1609362664 — MRS. KATRINA RENEE ISEMAN DPT
Practice Location Address:

12812 OLD GLENN HWY STE A3
EAGLE RIVER, AK
99577-7003

Practice Phone: 907-795-8115
Practice Fax:

1649744574 — MAKAYLA OLIVER
Practice Location Address:

12812 OLD GLENN HWY STE A3
EAGLE RIVER, AK
99577-7003

Practice Phone: 907-317-5895
Practice Fax:

1366000150 — ETTA ROBERTSON
Practice Location Address:

12812 OLD GLENN HWY STE A3
EAGLE RIVER, AK
99577-7003

Practice Phone: 907-317-5895
Practice Fax:

Directions to “PLAYFUL LEARNING PEDIATRIC THERAPY, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.