| NPI | 1164016689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN JEANETTE BENNETT Physical Therapist 907-617-6452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-02-24 |
| Last Update Date | 2021-02-24 |