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12201 Industry Way Ste 4, Anchorage, AK 99515-4316 | |
(907) 677-9653 | |
(907) 677-9657 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 12201 Industry Way Ste 4, Anchorage, Alaska |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700074382 | NPI | - | NPPES |
1694215 | Medicaid | AK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | 2030 (Hawaii) | Primary |
Provider Name | Korre L Pieper |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1427100122 PECOS PAC ID: 1456344985 Enrollment ID: I20130821000080 |
Provider Name | Taylor Ravoyd Liles |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1699364877 PECOS PAC ID: 6204225477 Enrollment ID: I20211109001213 |
Provider Name | Ruby Anna R Bulaoat |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1538618111 PECOS PAC ID: 1759661846 Enrollment ID: I20230221000709 |
Mailing Address | Practice Location Address |
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12201 Industry Way Ste 4, Anchorage, AK 99515-4316 Ph: (907) 677-9653 | 12201 Industry Way Ste 4, Anchorage, AK 99515-4316 Ph: (907) 677-9653 |