| NPI | 1962902197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANETTE M AVANT President/ Sole Owner 907-235-0687 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AK 1042393) |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2018-02-14 |