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SPINE AND SPORTS INJURY CENTER LLC NPI 1053690677


NPI Information

NPI: 1053690677
Provider Name: SPINE AND SPORTS INJURY CENTER, LLC

Doing Business As: COMPLETE FAMILY CARE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 02D2238338

Address:
1001 E BOGARD RD
WASILLA, AK
ZIP 99654
Phone: (907) 376-2225
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SPINE AND SPORTS INJURY CENTER, LLC is a family medicine in Wasilla, AK. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SPINE AND SPORTS INJURY CENTER, LLC NPI is 1053690677. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Complete Family Care.

The provider's business location address is:

1001 E BOGARD RD
WASILLA, AK
ZIP 99654-114
Phone: (907) 376-2225
Fax: (907) 376-9225

The provider's authorized official is Kristofer D Larson .
The authorized official title is Managing Member and has the following contact phone number (907) 376-2225.

The CLIA number assigned to this NPI record is 02D2238338 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/12/2011 and was last updated on 12/21/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111NS0005XChiropractorSports Physician435ALASKANo
2207Q00000XFamily MedicineYes
3225100000XPhysical TherapistNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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