Provider Demographics
NPI:1609915347
Name:SOUTH ANCHORAGE PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:SOUTH ANCHORAGE PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:K
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, DMT OCS
Authorized Official - Phone:907-868-8686
Mailing Address - Street 1:300 E DIMOND BLVD STE 16
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-1949
Mailing Address - Country:US
Mailing Address - Phone:907-868-8686
Mailing Address - Fax:907-868-3687
Practice Address - Street 1:300 E DIMOND BLVD STE 16
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1949
Practice Address - Country:US
Practice Address - Phone:907-868-8686
Practice Address - Fax:907-868-3687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK408692261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy