Provider Demographics
NPI:1225897069
Name:EMPOWER THERAPEUTICS LLC
Entity Type:Organization
Organization Name:EMPOWER THERAPEUTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:OTD; OTR/L
Authorized Official - Phone:907-743-7820
Mailing Address - Street 1:4050 LAKE OTIS PKWY STE 211
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5221
Mailing Address - Country:US
Mailing Address - Phone:907-743-7820
Mailing Address - Fax:907-743-7821
Practice Address - Street 1:4050 LAKE OTIS PKWY STE 211
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5221
Practice Address - Country:US
Practice Address - Phone:907-743-7820
Practice Address - Fax:907-743-7821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty