Individual
CATHERINE S MORMILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3003 MINNESOTA DR, SUITE 200, ANCHORAGE, AK 99503
(907) 355-3515
(907) 745-7269
Mailing address
PO BOX 3566, PALMER, AK 99645
(907) 355-3515
(907) 745-7269
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
313
AK
2251X0800X
Orthopedic Physical Therapist
Primary
PSYP313
AK
225X00000X
Occupational Therapist
354
AK
225XP0019X
Physical Rehabilitation Occupational Therapist
PSYO354
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209367
PHP GENERIC ID
—
01
—
75-1754187
TAX ID
AK
01
—
K0000WCKJT
MEDICARE GROUP
AK
05
—
PT0313
—
AK
Enumeration date
04/04/2006
Last updated
10/05/2018
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