| NPI | 1184022550 |
|---|---|
| Former Legal Business Name | BACKCOUNTRY THERAPEUTICS |
| Entity Type | Organization |
| Authorized Contact | ANDREA LEUTZINGER Owner, Provider 907-982-3897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AK 2195) |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2016-03-11 |