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NPI Code Detail

MEDICARE: ALASKA OT SERVICES, LLC

MEDICARE: ALASKA OT SERVICES, 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
1225X00000XOccupational Therapist495AK
2225XP0200XPediatric Occupational Therapist495AK

General Provider Information

NPI Number : 1801167002
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALASKA OT SERVICES, LLC
Provider Business Mailing Address
First Line : P.O. BOX #242761
Second Line :
City : ANCHORAGE
State : AK
Zip : 99524-2761
Country : US
Telephone Number : 907-223-2567
Fax Number :
Provider Business Practice Location Address
First Line : 124 E 23RD AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-2010
Country : US
Telephone Number : 907-223-2567
Fax Number :
Authorized Official
Title or Position : OCCUPATIONAL THERAPIST
Name : MAUREEN ANN JOHNSON
Credential : OT
Telephone Number : 907-223-2567
Provider Enumeration Date : 01/19/2012
Last Update Date : 02/20/2012

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Directions to “ALASKA OT SERVICES, LLC ” Practice Location

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