Provider Demographics
NPI:1952604910
Name:AURORA KID, LLC
Entity Type:Organization
Organization Name:AURORA KID, LLC
Other - Org Name:AURORA KIDS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:907-250-4450
Mailing Address - Street 1:PO BOX 670569
Mailing Address - Street 2:
Mailing Address - City:CHUGIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99567
Mailing Address - Country:US
Mailing Address - Phone:907-250-4450
Mailing Address - Fax:877-335-7623
Practice Address - Street 1:7335 EAST PALMER-WASILLA HIGHWAY
Practice Address - Street 2:SUITE 1A
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645
Practice Address - Country:US
Practice Address - Phone:907-250-4450
Practice Address - Fax:877-335-7623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-14
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPHY P 1032261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy