NPI | 1962693176 |
---|---|
Doing Business As | LIFE SPAN SUPPORT SERVICES |
Entity Type | Organization |
Authorized Contact | SUSAN K DALEIDEN Physical Therapist 907-272-1394 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: AK 314260) |
Enumeration Date | 2007-08-05 |
Last Update Date | 2012-03-22 |