Individual
JASON PATRICK PROUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3455 REWAK DR STE 106, FAIRBANKS, AK 99709-5024
(907) 457-5322
(907) 313-5322
Mailing address
3455 REWAK DR STE 106, FAIRBANKS, AK 99709-5024
(907) 457-5322
(907) 313-5322
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
052939
NY
225100000X
Physical Therapist
Primary
246377
AK
225100000X
Physical Therapist
P24412
NC
225100000X
Physical Therapist
PT61628802
WA
Other
Enumeration date
08/28/2024
Last updated
01/14/2026
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