| Premier Sports Medicine, Inc. | |
|
35670 Kenai Spur Hwy Ste 104 Soldotna AK 99669-7649 | |
| (907) 262-0801 | |
| (907) 262-0860 |
| Full Name | Premier Sports Medicine, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 35670 Kenai Spur Hwy Ste 104, Soldotna, Alaska |
| Authorized Official Name and Position | Cheryl Kay Larson (OWNER/OFFICE MANAGER) |
| Authorized Official Contact | 9072620801 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Sports Medicine, Inc. 35670 Kenai Spur Hwy Ste 104 Soldotna AK 99669-7649 Ph: (907) 262-0801 | Premier Sports Medicine, Inc. 35670 Kenai Spur Hwy Ste 104 Soldotna AK 99669-7649 Ph: (907) 262-0801 |
| NPI Number | 1659846293 |
|---|---|
| Provider Enumeration Date | 10/10/2018 |
| Last Update Date | 10/10/2018 |
| Medicare PECOS PAC ID | 9234523127 |
|---|---|
| Medicare Enrollment ID | O20220217002310 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659846293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Brian E Larson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1952473415 PECOS PAC ID: 5092733022 Enrollment ID: I20060112000030 |
| Provider Name | Hannah Lawson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558971721 PECOS PAC ID: 4385054832 Enrollment ID: I20230522001526 |
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