| NPI | 1124497540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS WILSON Owner 907-694-5515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: AK 1021707) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2020-01-22 |