Provider Demographics
NPI:1669017398
Name:RUNNERS EDGE ALASKA
Entity Type:Organization
Organization Name:RUNNERS EDGE ALASKA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZUZANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:907-929-9009
Mailing Address - Street 1:11124 OLD SEWARD HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-0001
Mailing Address - Country:US
Mailing Address - Phone:907-929-9009
Mailing Address - Fax:907-312-7143
Practice Address - Street 1:11124 OLD SEWARD HWY STE 200
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-0001
Practice Address - Country:US
Practice Address - Phone:907-929-9009
Practice Address - Fax:907-312-7143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-18
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty