Organization
PHYSICAL THERAPY FOR KIDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHARON SKIDMORE P.T., D.P.T. (OWNER)
(907) 346-4096
Entity
Organization
Contact information
Practice address
1109 N FOREST EDGE DR, SISTERS, OR 97759-2692
(907) 346-4096
(877) 319-7365
Mailing address
PO BOX 1475, SISTERS, OR 97759-1475
(907) 346-4096
(907) 346-4097
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
783
AK
2251P0200X
Pediatric Physical Therapist
783
AK
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021227
—
AK
05
—
500791711
—
OR
Enumeration date
09/08/2009
Last updated
06/22/2021
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