| Willow Physical Therapy, Limited | |
|
544 4th Ave # 102, Fairbanks, AK 99701-4714 | |
| (907) 456-5990 | |
| (907) 374-8023 |
| Full Name | Willow Physical Therapy, Limited |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist - Orthopedic |
| Location | 544 4th Ave # 102, Fairbanks, Alaska |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831123165 | NPI | - | NPPES |
| 1021170 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2251X0800X | Physical Therapist - Orthopedic | 183875 (Alaska) | Primary |
| Provider Name | Aisha C Wilbur |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619113123 PECOS PAC ID: 6204992589 Enrollment ID: I20091009000272 |
| Provider Name | Cassidee R Stumbo |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174220362 PECOS PAC ID: 5698140291 Enrollment ID: I20230413000713 |
| Provider Name | Paul Johnson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1740972405 PECOS PAC ID: 5395287544 Enrollment ID: I20240604001320 |
| Provider Name | Raquel S Koch |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760132823 PECOS PAC ID: 2264896729 Enrollment ID: I20240611002147 |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Physical Therapy, Limited 544 4th Ave Ste 102, Fairbanks, AK 99701-4714 Ph: (907) 456-5990 | Willow Physical Therapy, Limited 544 4th Ave # 102, Fairbanks, AK 99701-4714 Ph: (907) 456-5990 |
Lauren Pantone, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1650 Cowles St, Fairbanks, AK 99701 Phone: 907-458-5670 | |
Tara J Scogin, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1275 Sadler Way, Suite 201, Fairbanks, AK 99701 Phone: 907-374-0992 | |
Mrs. Johnna Renee Underwood, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 459 Farmers Loop Rd, Fairbanks, AK 99712 Phone: 907-550-0587 | |
Susan Grace Mcdiarmid, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 751 Old Richardson Hwy, #202, Fairbanks, AK 99701 Phone: 907-455-4401 Fax: 907-455-4402 | |
Ms. Mary Jones, M.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2166 Yellow Leaf Ct, Fairbanks, AK 99709 Phone: 907-455-6875 | |
Emily Roberts Rogers, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1275 Sadler Way, Ste 201, Fairbanks, AK 99701 Phone: 907-374-0992 Fax: 907-374-0986 | |
Elizabeth Lee Myers, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 158 Frog Pond Cir, Fairbanks, AK 99712 Phone: 907-251-5472 Fax: 907-600-1823 |