| Jaded Body Wellness & Spine Institute, Llc | |
|
645 N Jessica Brooke Circle, Ste C, Wasilla, AK 99654-7333 | |
| (907) 631-0600 | |
| (907) 631-3032 |
| Full Name | Jaded Body Wellness & Spine Institute, Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 645 N Jessica Brooke Circle, Wasilla, Alaska |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306108543 | NPI | - | NPPES |
| PT0068 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 2028 (Alaska) | Primary |
| Provider Name | Jade Walter Ekle |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467499855 PECOS PAC ID: 0648283010 Enrollment ID: I20250220001349 |
| Provider Name | Nicole Marie Rogers |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1235249806 PECOS PAC ID: 4981739471 Enrollment ID: I20250317003166 |
| Provider Name | Elizabeth Boshears |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720724180 PECOS PAC ID: 3476931734 Enrollment ID: I20250321003426 |
| Provider Name | Joseph Scott Reiser |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578139911 PECOS PAC ID: 7719382381 Enrollment ID: I20250415003444 |
| Mailing Address | Practice Location Address |
|---|---|
| Jaded Body Wellness & Spine Institute, Llc 645 N Jessica Brooke Circle, Ste C, Ste C, Wasilla, AK 99654-7333 Ph: (907) 631-0600 | Jaded Body Wellness & Spine Institute, Llc 645 N Jessica Brooke Circle, Ste C, Wasilla, AK 99654-7333 Ph: (907) 631-0600 |
Amy Lynn Sauck, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1700 E Bogard Rd, Suite B203, Wasilla, AK 99654 Phone: 907-376-4325 | |
Russell Burlingame, PT, MS Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 401 E Bogard Rd, Wasilla, AK 99654 Phone: 907-357-2578 | |
Keith Poorbaugh, PT, SCD, OCS, FAAOMP Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 984 N Meridian Pl, # A, Wasilla, AK 99654 Phone: 907-631-4029 Fax: 907-631-4128 | |
Jessica Ann Bruscher, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3543 E. Meridian Park Loop, Wasilla, AK 99654 Phone: 605-280-8413 | |
Andrea Stauner, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 401 E Bogard Rd, Wasilla, AK 99654 Phone: 907-357-2578 Fax: 907-357-2529 | |
Wasilla Physical Therapy Inc. Physical Therapist Medicare: Medicare Enrolled Practice Location: 3750 E Country Field Cir Ste A, Wasilla, AK 99654 Phone: 907-376-7334 Fax: 907-373-1429 | |
Marcia Everson, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 650 N Shoreline Dr, Wasilla, AK 99654 Phone: 907-376-6363 Fax: 907-376-6366 |