| Organization Name: | WASILLA PHYSICAL THERAPY INC. |
| NPI Number: | 1023364205 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT ORVILLE BROWN (OWNER/MANAGER) |
| Mailing Address: | 3750 E Country Field Cir Ste A Wasilla |
| State: | AK US |
| Postal Code: | 996546659 |
| Phone Number: | 9073767334 |
| Fax Number: | 9073731429 |
| NPI Enumeration Date: | 07/25/2012 |
| NPI Last Update Date: | 07/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| 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 |