MEDICARE: LOUIS GREENE PT

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	225100000X	Physical Therapist	1400	AK

General Provider Information

NPI Number	:	1740210012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIS GREENE PT

Provider Business Mailing Address
First Line	:	PO BOX 241889
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99524-1889
Country	:	US
Telephone Number	:	907-563-1777
Fax Number	:	907-561-7464

Provider Business Practice Location Address
First Line	:	4001 LAKE OTIS PKWY STE 201
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5200
Country	:	US
Telephone Number	:	907-561-1711
Fax Number	:	907-561-6676

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	08/05/2022

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Directions to “ LOUIS GREENE PT” Practice Location

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