M2B Holdings

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2365 Issued in AK

Legal business name

M2B HOLDINGS

Doing business as

Arctic Raven Physical Therapy

Practice address

11401 Old Glenn Hwy
#110
Eagle River, AK 99577-7747

Phone

(808) 276-4236

NPI assigned

Jul 8, 2015

Last updated

Jul 8, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brenda Yvonne Wong

Title

Physical Therapist & Owner

Phone

(808) 276-4236

Specialties & licenses 1

Addresses

Other names 1

• Arctic Raven Physical Therapy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436313600000",
    "number": "1871976837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11401 OLD GLENN HWY",
            "address_2": "#110",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777747",
            "telephone_number": "808-276-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 OLD GLENN HWY",
            "address_2": "#110",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777747",
            "telephone_number": "808-276-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M2B HOLDINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-08",
        "last_updated": "2015-07-08",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "YVONNE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST & OWNER",
        "authorized_official_telephone_number": "808-276-4236"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "2365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arctic Raven Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zachary Michael Luebbers
• April Lunn, BA
• Nicholas Lynch
• Brandee Lynn
• Dianne E Lyons, RBT
• Jennifer Machacek
• Gregory Madden, D.C.
• Agak Makoi
• Amey Malone, CFY-SLP
• Omar Manneh

• Physical Therapist in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Physical Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.