MEDICARE: AFT MEDICAL AK LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207X00000X	Orthopaedic Surgery Physician
2	363A00000X	Physician Assistant
3	363L00000X	Nurse Practitioner
4	202D00000X	Integrative Medicine Physician

General Provider Information

NPI Number	:	1770302374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFT MEDICAL AK LLC

Provider Business Mailing Address
First Line	:	4739 EGRET ROCK CIR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-4390
Country	:	US
Telephone Number	:	559-284-4135
Fax Number	:

Provider Business Practice Location Address
First Line	:	4739 EGRET ROCK CIR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-4390
Country	:	US
Telephone Number	:	559-284-4135
Fax Number	:

Authorized Official
Title or Position	:	CEO / MEDICAL DIRECTOR
Name	:	DR. RYAN T MOORE
Credential	:	MD
Telephone Number	:	831-917-8761

Provider Enumeration Date	:	10/09/2024
Last Update Date	:	12/16/2024

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Directions to “AFT MEDICAL AK LLC ” Practice Location

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