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Organization
KJT, LLC
Active
Organization
KJT, LLC
Active
Other names
Black Mountain Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
KATI JO TUMA MMS, PA-C (OWNER)
(307) 267-6150
Entity
Organization
Contact information
Practice address
1314 SHUROS DR, FAIRBANKS, AK 99709-6740
(307) 267-6150
(833) 986-3605
Mailing address
560 GRANITE PEAK DR APT 102, CASPER, WY 82609-4522
(307) 267-6150
(833) 986-3605
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
—
NULL
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
—
—
261Q00000X
Clinic/Center
—
NULL
261QH0100X
Health Service Clinic/Center
—
NULL
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
261QP2000X
Physical Therapy Clinic/Center
—
NULL
261QP3300X
Pain Clinic/Center
—
NULL
Other
Enumeration date
07/30/2025
Last updated
07/30/2025
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