| Revolution Sport & Spine Therapy Llc | |
|
35249 Kenai Spur Hwy, Suite C, Soldotna, AK 99669-7623 | |
| (541) 913-3089 | |
| Not Available |
| Full Name | Revolution Sport & Spine Therapy Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist - Orthopedic |
| Location | 35249 Kenai Spur Hwy, Soldotna, Alaska |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598215170 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2251X0800X | Physical Therapist - Orthopedic | 1042783 (Alaska) | Primary |
| Provider Name | Thomas T Wells |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1477683993 PECOS PAC ID: 7012985161 Enrollment ID: I20040920000157 |
| Provider Name | Haley D Bowen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1124211750 PECOS PAC ID: 3274629209 Enrollment ID: I20071022000429 |
| Provider Name | Emily R Rogers |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073940128 PECOS PAC ID: 0244466530 Enrollment ID: I20131114001241 |
| Provider Name | Chelsea Ludlow |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770031767 PECOS PAC ID: 2668769431 Enrollment ID: I20160921002409 |
| Provider Name | Jason Edward Buckbee |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881927242 PECOS PAC ID: 2466732359 Enrollment ID: I20161212001180 |
| Provider Name | Bryan Daniel Frapp |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669726220 PECOS PAC ID: 0042590945 Enrollment ID: I20161212001496 |
| Provider Name | Mark Edward Cunningham |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770601387 PECOS PAC ID: 8022927326 Enrollment ID: I20161212002149 |
| Provider Name | Alexi R Charter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720461312 PECOS PAC ID: 0941519680 Enrollment ID: I20170323001107 |
| Provider Name | Heather Johnson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346466489 PECOS PAC ID: 2365627643 Enrollment ID: I20170727001872 |
| Provider Name | Mavrick Kuzmin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1962938423 PECOS PAC ID: 3274801808 Enrollment ID: I20170808001762 |
| Provider Name | Daniel M King |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518305770 PECOS PAC ID: 2860632734 Enrollment ID: I20181008002462 |
| Provider Name | Taylor A Robinson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316374887 PECOS PAC ID: 8628204328 Enrollment ID: I20181205003730 |
| Provider Name | David Seramur |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437566635 PECOS PAC ID: 4082046297 Enrollment ID: I20191108001511 |
| Provider Name | Mariah A. Kellogg |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629694112 PECOS PAC ID: 4789009838 Enrollment ID: I20200806000470 |
| Provider Name | Bryan P Harter |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063672392 PECOS PAC ID: 6204252091 Enrollment ID: I20200811001912 |
| Provider Name | Robert Hodges |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699107219 PECOS PAC ID: 9234373093 Enrollment ID: I20201201001667 |
| Provider Name | Clayton Ryan Henson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457968745 PECOS PAC ID: 8022424159 Enrollment ID: I20210315002005 |
| Provider Name | Abigail K Holmes |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699333914 PECOS PAC ID: 6901130814 Enrollment ID: I20210625002722 |
| Provider Name | Elaina Groby |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871153452 PECOS PAC ID: 9739580812 Enrollment ID: I20210626000051 |
| Provider Name | Madeline Ann Miller |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295400737 PECOS PAC ID: 2264821214 Enrollment ID: I20211111002421 |
| Provider Name | Christopher Michael Richter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942728043 PECOS PAC ID: 3971835869 Enrollment ID: I20211220001250 |
| Provider Name | Savannah Jeane Lyons |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134852007 PECOS PAC ID: 0143601054 Enrollment ID: I20220722001102 |
| Provider Name | Tiffany M Mccorison |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578600904 PECOS PAC ID: 6002918539 Enrollment ID: I20220920001514 |
| Provider Name | Angela Harter |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1396071783 PECOS PAC ID: 2365801545 Enrollment ID: I20230706001542 |
| Provider Name | Luis Enrique Reyes Mendieta |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033895081 PECOS PAC ID: 9931561115 Enrollment ID: I20230821001322 |
| Mailing Address | Practice Location Address |
|---|---|
| Revolution Sport & Spine Therapy Llc 35249 Kenai Spur Hwy, Suite C, Soldotna, AK 99669-7623 Ph: (907) 420-0836 | Revolution Sport & Spine Therapy Llc 35249 Kenai Spur Hwy, Suite C, Soldotna, AK 99669-7623 Ph: (541) 913-3089 |
Luis Enrique Reyes Mendieta, Physical Therapist Medicare: Medicare Enrolled Practice Location: 35249 Kenai Spur Hwy, Soldotna, AK 99669 Phone: 907-781-3227 | |
Mrs. Stacy Lee Brantley, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 35551 Kenai Spur Hwy, Soldotna, AK 99669 Phone: 907-714-4534 Fax: 907-262-4783 | |
Christy Nicole Warren, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 44604 Sterling Hwy, Unit A, Soldotna, AK 99669 Phone: 907-420-0640 Fax: 907-420-0630 | |
Alaskan Physical Therapy, Inc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 36275 Kenai Spur Hwy, Suite 5, Soldotna, AK 99669 Phone: 907-260-2679 Fax: 907-260-2676 | |
Zachary Michael Huot, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 230 E Marydale Ave, Soldotna, AK 99669 Phone: 907-262-3119 Fax: 907-262-9290 | |
Savannah Jeane Lyons, SPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 35249 Kenai Spur Hwy Ste C, Soldotna, AK 99669 Phone: 907-420-0836 Fax: 907-420-0837 | |
Aspen Physical Therapy Pc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 221 W. Marydale Ave, Soldotna, AK 99669 Phone: 907-262-2596 |