KETCHIKAN PHYSICAL THERAPY LLC NPI 1801437090

NPI Information

NPI: 1801437090
Provider Name: KETCHIKAN PHYSICAL THERAPY, LLC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 02D0934737

Address:
21 JEFFERSON WAY STE 202
KETCHIKAN, AK
ZIP 99901
Phone: (907) 617-2052
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KETCHIKAN PHYSICAL THERAPY, LLC is a health service clinic center in Ketchikan, AK. KETCHIKAN PHYSICAL THERAPY, LLC NPI is 1801437090. The provider is registered as an organization entity type.

The provider's business location address is:

21 JEFFERSON WAY STE 202
KETCHIKAN, AK
ZIP 99901-951
Phone: (907) 617-2052

The provider's authorized official is Amanda Marie Davidshofer .
The authorized official title is Physical Therapist and has the following contact phone number (907) 617-2052.

The CLIA number assigned to this NPI record is 02D0934737 - federally qualified health center with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 9/30/2019 and was last updated on 9/30/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			Yes

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

NPI Synchronization or Removal

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