Provider Demographics
NPI:1962651554
Name:VANKOOTEN, KARA DAWN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:DAWN
Last Name:VANKOOTEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11260 OLD SEWARD HWY
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3038
Mailing Address - Country:US
Mailing Address - Phone:907-341-5555
Mailing Address - Fax:907-341-5755
Practice Address - Street 1:11260 OLD SEWARD HWY
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-3038
Practice Address - Country:US
Practice Address - Phone:907-341-5555
Practice Address - Fax:907-341-5755
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1992225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist