Provider Demographics
NPI:1831848530
Name:ARCTIC REHABILITATION AND PHYSICAL THERAPY HOMER
Entity type:Organization
Organization Name:ARCTIC REHABILITATION AND PHYSICAL THERAPY HOMER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-250-7246
Mailing Address - Street 1:1150 S COLONY WAY STE 3-226
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-6967
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:345 STERLING HWY STE 102A
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:AK
Practice Address - Zip Code:99603-7820
Practice Address - Country:US
Practice Address - Phone:907-435-0526
Practice Address - Fax:907-435-0527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-21
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy