Organization
NORTHERN EDGE PHYSICAL THERAPY LLC
Active
Other names
Northern Edge Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH POORBAUGH PT, SCD (OWNER/MANAGER)
(907) 631-4029
Entity
Organization
Contact information
Practice address
984 N MERIDIAN PL STE A, WASILLA, AK 99654-7215
(907) 631-4029
(907) 631-4128
Mailing address
984 N MERIDIAN PL # A, WASILLA, AK 99654-7215
(907) 631-4029
(907) 631-4128
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1581
AK
Other
Enumeration date
11/16/2012
Last updated
04/12/2022
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