Doctor Name: | SUSAN V PETTIS |
NPI Number: | 1346204658 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 67 |
Business Practice Address: | 11551 Tanglewood Lake Circle Suite 2 Anchorage, AK - 995161304 |
Business Phone Number: | 9075627745 |
Business Fax Number: | 9075627808 |
Mailing Address: | Po Box 241769, ANCHORAGE |
State: | AK |
Postal Code: | 995241769 |
Phone Number: | 9077702380 |
Fax Number: | 9077702341 |
NPI Enumeration Date: | 04/13/2006 |
NPI Last Update Date: | 09/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 67 |
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 |