Provider Demographics
NPI:1396815759
Name:LAZZARINI, JANA M'LYN (PT)
Entity type:Individual
Prefix:MRS
First Name:JANA
Middle Name:M'LYN
Last Name:LAZZARINI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:JANA
Other - Middle Name:M'LYN
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1917 ABBOTT RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-3449
Mailing Address - Country:US
Mailing Address - Phone:907-279-4266
Mailing Address - Fax:907-279-4272
Practice Address - Street 1:3051 E PALMER WASILLA HWY
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7234
Practice Address - Country:US
Practice Address - Phone:907-376-8590
Practice Address - Fax:907-376-8584
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK216022225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist