Mark Alzona

Individual provider Active NPI Physical Therapist · Pago Pago, AS

NPI 1073258562 · NPPES record last updated Apr 29, 2022

Key facts

NPI
1073258562
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
4106C (AS)
Practice address
11155 Turner Drive
Pago Pago, AS 96799-0010
Phone
(684) 633-1222
Fax
(684) 633-2893
NPI assigned
Apr 29, 2022
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4106CASMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4106C AS Yes

Addresses

Primary practice location

11155 Turner Drive
Pago Pago, AS 96799-0010

Mailing address

PO Box LBJ
Pago Pago, AS 96799-0010
Phone (684) 633-1222

Other providers in Pago Pago, AS

All providers in Pago Pago, AS · Physical Therapist in American Samoa

Sources for this page

Verify at the official NPI Registry.