Provider Demographics
NPI:1265097679
Name:JUNEAU MOBILE THERAPY LLC
Entity type:Organization
Organization Name:JUNEAU MOBILE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DPT
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:FELKE-CAF
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:907-419-7253
Mailing Address - Street 1:1003 BONNIE DOON DR
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-9441
Mailing Address - Country:US
Mailing Address - Phone:907-500-2220
Mailing Address - Fax:
Practice Address - Street 1:1003 BONNIE DOON DR
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-9441
Practice Address - Country:US
Practice Address - Phone:907-500-2220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-01
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty