Provider Demographics
NPI:1205850674
Name:FIRST CHOICE PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:FIRST CHOICE PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:AUGUST
Authorized Official - Last Name:LEPAGE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:907-357-9755
Mailing Address - Street 1:PO BOX 298658
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99629-8658
Mailing Address - Country:US
Mailing Address - Phone:907-357-9755
Mailing Address - Fax:907-357-9499
Practice Address - Street 1:6701 W. BLONDELL ST.
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654
Practice Address - Country:US
Practice Address - Phone:907-357-9755
Practice Address - Fax:907-357-9499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy