Provider Demographics
NPI:1487847893
Name:COSGRAVE, DAVID VALENTINE (LAC LMT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:VALENTINE
Last Name:COSGRAVE
Suffix:
Gender:M
Credentials:LAC LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 ARTIC BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-7068
Mailing Address - Country:US
Mailing Address - Phone:907-337-4246
Mailing Address - Fax:
Practice Address - Street 1:5001 ARTIC BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-7068
Practice Address - Country:US
Practice Address - Phone:907-337-4246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK0069171100000X
AKMT 1181225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist