Individual
RUSSELL BURLINGAME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, MS
Contact information
Practice address
401 E BOGARD RD, WASILLA, AK 99654-7108
(907) 357-2578
Mailing address
401 E BOGARD RD, WASILLA, AK 99654-7108
(907) 357-2578
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1175
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PT 1175
—
AK
Enumeration date
05/23/2006
Last updated
03/05/2026
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