Provider Demographics
NPI:1619147881
Name:A T G INC
Entity Type:Organization
Organization Name:A T G INC
Other - Org Name:THERAPEUTIC REHAB.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PISCITELLI-ENDERS
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:907-341-7722
Mailing Address - Street 1:300 E DIMOND BLVD STE 12
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-1948
Mailing Address - Country:US
Mailing Address - Phone:907-341-7722
Mailing Address - Fax:907-341-7763
Practice Address - Street 1:300 E DIMOND BLVD STE 12
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1948
Practice Address - Country:US
Practice Address - Phone:907-341-7722
Practice Address - Fax:907-341-7763
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THERAPEUTIC REHAB.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK769261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation