Organization
KIDABILITY PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN MARIE BACON PT (OWNER)
(907) 230-0402
Entity
Organization
Contact information
Practice address
6406 S. GONDER ROAD, BIG LAKE, AK 99652
(907) 230-0402
Mailing address
PO BOX 521504, BIG LAKE, AK 99652-1504
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT1159
AK
Other
Enumeration date
01/31/2013
Last updated
01/31/2013
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