| 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 |