Marlecia Holston, PT, DPT
Individual provider Active NPI Physical Therapist · North Pole, AK
NPI 1427705482 · NPPES record last updated Sep 24, 2024
Key facts
- NPI
- 1427705482
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 188671 (AK)
- Practice address
- 2249 Moonlight Dr
North Pole, AK 99705-5892 - Phone
- (740) 262-8210
- NPI assigned
- Mar 9, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220321000005 | AK | Practitioner - Physical Therapist in Private Practice | 4486049970 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Physical Therapy Inc | Physical Therapist | Current |
Accepting new patients |
| Adient Alaska, LLC | Physical Therapist | Current |
Accepting new patients |
Locations
1917 Abbott Rd
Ste 200
Anchorage, AK 99507
Phone (907) 279-4266
1275 Sadler Way
Ste 201
Fairbanks, AK 99701
Phone (907) 374-0992
1919 Lathrop St
Ste 123
Fairbanks, AK 99701
Phone (907) 290-3075
3745 Geist Rd
Fairbanks, AK 99709
Phone (907) 456-1112
3051 E Palmer Wasilla Hwy
Wasilla, AK 99654
Phone (907) 352-4800
790 Remington Blvd
Bolingbrook, IL 60440
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 188671 | AK | Yes |
Addresses
Primary practice location
2249 Moonlight Dr
North Pole, AK 99705-5892
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Other providers in North Pole, AK
- Brianne Henderson
- Amy Ann Hendrickson
- Bonny J Holm
- Leif Joseph Holm
- Richard Clayton Holm
- Hunny Bunny'S Alh, LLC
- Angela Hutwagner
- Interior Behavior Consulting, LLC
- Christopher Robert Jackson
- Megan Jackson
All providers in North Pole, AK · Physical Therapist in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.