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1001 E Bogard Rd, Wasilla, AK 99654-7114 | |
| (907) 376-2225 | |
| (907) 376-9225 |
| Full Name | |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 1001 E Bogard Rd, Wasilla, Alaska |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356621395 | NPI | - | NPPES |
| 1683033 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| 225200000X | Physical Therapy Assistant | (* (Not Available)) | Secondary |
| Provider Name | Michelle Hennessey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639132517 PECOS PAC ID: 7214267996 Enrollment ID: I20190926002198 |
| Provider Name | Briana Catherine Leatham |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912552795 PECOS PAC ID: 9234469560 Enrollment ID: I20190929000019 |
| Provider Name | David Farmer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1386109239 PECOS PAC ID: 7810236494 Enrollment ID: I20211102000612 |
| Provider Name | Abbigail Dauterman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093329070 PECOS PAC ID: 0749657641 Enrollment ID: I20230628001144 |
| Provider Name | Alex Moldovan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669044582 PECOS PAC ID: 3779950944 Enrollment ID: I20230705001042 |
| Provider Name | Abby Regier |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215501531 PECOS PAC ID: 9739582081 Enrollment ID: I20240402003823 |
| Provider Name | Gage Kerns |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336713650 PECOS PAC ID: 0143621482 Enrollment ID: I20240408001199 |
| Mailing Address | Practice Location Address |
|---|---|
1001 E Bogard Rd, Wasilla, AK 99654-7114 Ph: (907) 376-2225 | 1001 E Bogard Rd, Wasilla, AK 99654-7114 Ph: (907) 376-2225 |
Amy Lynn Sauck, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1700 E Bogard Rd, Suite B203, Wasilla, AK 99654 Phone: 907-376-4325 | |
Russell Burlingame, PT, MS Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 401 E Bogard Rd, Wasilla, AK 99654 Phone: 907-357-2578 | |
Keith Poorbaugh, PT, SCD, OCS, FAAOMP Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 984 N Meridian Pl, # A, Wasilla, AK 99654 Phone: 907-631-4029 Fax: 907-631-4128 | |
Jessica Ann Bruscher, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3543 E. Meridian Park Loop, Wasilla, AK 99654 Phone: 605-280-8413 | |
Andrea Stauner, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 401 E Bogard Rd, Wasilla, AK 99654 Phone: 907-357-2578 Fax: 907-357-2529 | |
Wasilla Physical Therapy Inc. Physical Therapist Medicare: Medicare Enrolled Practice Location: 3750 E Country Field Cir Ste A, Wasilla, AK 99654 Phone: 907-376-7334 Fax: 907-373-1429 | |
Marcia Everson, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 650 N Shoreline Dr, Wasilla, AK 99654 Phone: 907-376-6363 Fax: 907-376-6366 |