Marlys F Bryan, RPT
Individual provider Active NPI Physical Therapist · Wasilla, AK
NPI 1598936635 · NPPES record last updated Apr 22, 2019
Key facts
- NPI
- 1598936635
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 650 N Shoreline Dr
Wasilla, AK 99654-6677 - Phone
- (907) 376-6363
- NPI assigned
- Mar 17, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220701001370 | MT | Practitioner - Physical Therapist in Private Practice | 2163732371 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspire Physical Therapy PLLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | AK | Yes |
Addresses
Primary practice location
650 N Shoreline Dr
Wasilla, AK 99654-6677
Mailing address
801 L St
Fairbury, NE 68352-2140
Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2019. 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.