Kidability Physical Therapy, LLC
Organization Active NPI Pediatric Physical Therapist · Big Lake, AK
NPI 1891034575 · NPPES record last updated Jan 31, 2013
Key facts
- NPI
- 1891034575
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatric Physical Therapist 2251P0200X
- License
- PT1159 (AK)
- Legal business name
- KIDABILITY PHYSICAL THERAPY, LLC
- Practice address
- 6406 S. Gonder Road
Big Lake, AK 99652 - Phone
- (907) 230-0402
- NPI assigned
- Jan 31, 2013
- Organization subpart
- No
Authorized official
- Name
- Kristin Marie Bacon, PT
- Title
- Owner
- Phone
- (907) 230-0402
Practitioners 1
-
Kristin M Bacon, PT
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist |
2251P0200X | PT1159 | AK | Yes |
Addresses
Primary practice location
6406 S. Gonder Road
Big Lake, AK 99652
Mailing address
PO Box 521504
Big Lake, AK 99652-1504
Other providers in Big Lake, AK
- Janet L Bogard
- Amber Renae Braaten
- Julie Dittman
- Heather Ruth Edgren
- Nikki Johnson
- Lakeview Massage Therapy
- Jennifer Lloyd
- Margaret Maixner
- Renae Jean Nelson
- Brenda Kay Perkins
All providers in Big Lake, AK · Pediatric 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 Jan 31, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.