Doctor Name: | KEITH POORBAUGH |
NPI Number: | 1003971037 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT, SCD, OCS, FAAOMP |
License Number: | 1581 |
Business Practice Address: | 1830 E Parks Hwy Suite A-137 Wasilla, AK - 996547378 |
Business Phone Number: | 9076314029 |
Business Fax Number: | 9076314128 |
Mailing Address: | 1830 E Parks Hwy, Suite A-137 WASILLA |
State: | AK |
Postal Code: | 996547378 |
Phone Number: | 9076314029 |
Fax Number: | 9076314128 |
NPI Enumeration Date: | 12/27/2006 |
NPI Last Update Date: | 07/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1581 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |