# KIDABILITY PHYSICAL THERAPY, LLC

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

## Provider details

- **NPI number:** 1891034575
- **Authorized official:** KRISTIN MARIE BACON PT (OWNER)
- **Authorized official phone:** (907) 230-0402

## Contact information

- **Practice address:** 6406 S. GONDER ROAD, BIG LAKE, AK 99652
- **Practice address phone:** (907) 230-0402
- **Mailing address:** PO BOX 521504, BIG LAKE, AK 99652-1504

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251P0200X | Pediatric Physical Therapist | PT1159 | AK | Yes |

## Other

- **Enumeration date:** 01/31/2013
- **Last updated:** 01/31/2013