# FUNCTIONAL THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083759021
- **Authorized official:** JERRY PASOL OTR (OTR)
- **Authorized official phone:** (907) 334-9002

## Contact information

- **Practice address:** 6613 BRAYTON DR, SUITE A, ANCHORAGE, AK 99507-2127
- **Practice address phone:** (907) 334-9002
- **Practice address fax:** (907) 334-9320
- **Mailing address:** PO BOX 113394, ANCHORAGE, AK 99511-3394
- **Mailing address phone:** (907) 334-9002
- **Mailing address fax:** (907) 334-9320

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251P0200X | Pediatric Physical Therapist | — | AK | Yes |
| 225XP0200X | Pediatric Occupational Therapist | — | AK | — |

## Other

- **Enumeration date:** 02/20/2007
- **Last updated:** 09/11/2025