Individual
DR. MICHELLE HENNESSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1001 E BOGARD RD, WASILLA, AK 99654-7114
(907) 373-7246
(907) 376-9225
Mailing address
1001 E BOGARD RD, WASILLA, AK 99654-7114
(907) 373-7246
(907) 376-9225
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
100023
AK
225100000X
Physical Therapist
6726
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1683033
—
AK
Enumeration date
04/11/2006
Last updated
03/09/2021
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