Provider Demographics
NPI:1336699842
Name:MEASEL, ZACHARY ADAM (DPT)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:ADAM
Last Name:MEASEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 RUSSIAN JACK DR
Mailing Address - Street 2:APT #22
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-6004
Mailing Address - Country:US
Mailing Address - Phone:907-764-5828
Mailing Address - Fax:
Practice Address - Street 1:360 BONIFACE PKWY
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-4900
Practice Address - Country:US
Practice Address - Phone:907-563-2142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH016601225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist