Organization
RAVEN'S SONG REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA DAWN FERGUSON-WHEELER PT (OWNER)
(907) 315-7949
Entity
Organization
Contact information
Practice address
6811 W SCATTERS WAY, WASILLA, AK 99623-0878
(907) 315-7949
(877) 220-7510
Mailing address
6811 W SCATTERS WAY, WASILLA, AK 99623-0878
(907) 315-7949
(877) 220-7510
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1004364
AK
Other
Enumeration date
07/09/2014
Last updated
07/09/2014
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