Provider Demographics
NPI:1740668276
Name:KONNEKTING LYNX LLC
Entity type:Organization
Organization Name:KONNEKTING LYNX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONAL MANAGER
Authorized Official - Prefix:PROF
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, BHS
Authorized Official - Phone:907-792-9525
Mailing Address - Street 1:2900 BONIFACE PKWY
Mailing Address - Street 2:SUITE #220
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-3132
Mailing Address - Country:US
Mailing Address - Phone:907-792-9525
Mailing Address - Fax:
Practice Address - Street 1:2900 BONIFACE PKWY
Practice Address - Street 2:SUITE #220
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-3132
Practice Address - Country:US
Practice Address - Phone:907-792-9525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-17
Last Update Date:2015-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1020633225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty