| Organization Name: | KIDABILITY PHYSICAL THERAPY, LLC |
| NPI Number: | 1891034575 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRISTIN MARIE BACON (OWNER) |
| Mailing Address: | 6406 S. Gonder Road Big Lake |
| State: | AK US |
| Postal Code: | 99652 |
| Phone Number: | 9072300402 |
| Fax Number: | |
| NPI Enumeration Date: | 01/31/2013 |
| NPI Last Update Date: | 01/31/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | PT1159 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |