Individual
DR. STEPHANIE WIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
3065 COLLEGE RD, FAIRBANKS, AK 99709-3702
(907) 374-1686
Mailing address
3065 COLLEGE RD, FAIRBANKS, AK 99709-3702
(907) 374-1686
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
121582
AK
225100000X
Physical Therapist
20561
MA
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002573
—
AK
Enumeration date
06/05/2015
Last updated
10/23/2019
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