Organization
JADED BODY WELLNESS & SPINE INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAPRICE CARTER (BILLING)
(907) 631-0600
Entity
Organization
Contact information
Practice address
645 N JESSICA BROOKE CIRCLE, STE C, WASILLA, AK 99654-7333
(907) 631-0600
(907) 631-3032
Mailing address
645 N JESSICA BROOKE CIRCLE, STE C, STE C, WASILLA, AK 99654-7333
(907) 631-0600
(907) 631-3032
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2028
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PT0068
—
AK
Enumeration date
06/13/2012
Last updated
10/28/2024
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