| Altair Integrative Wellness | |
|
3161 E Palmer Wasilla Hwy Ste 1c Wasilla AK 99654-7271 | |
| (907) 357-1818 | |
| (907) 357-1814 |
| Full Name | Altair Integrative Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 3161 E Palmer Wasilla Hwy Ste 1c, Wasilla, Alaska |
| Authorized Official Name and Position | Tara E Workman Dc (CEO) |
| Authorized Official Contact | 9073571818 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Altair Integrative Wellness 3161 E Palmer Wasilla Hwy Ste 1c Wasilla AK 99654-7271 Ph: (907) 357-1818 | Altair Integrative Wellness 3161 E Palmer Wasilla Hwy Ste 1c Wasilla AK 99654-7271 Ph: (907) 357-1818 |
| NPI Number | 1932744836 |
|---|---|
| Provider Enumeration Date | 11/14/2019 |
| Last Update Date | 12/30/2019 |
| Medicare PECOS PAC ID | 9133553464 |
|---|---|
| Medicare Enrollment ID | O20191219001806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932744836 | NPI | - | NPPES |
| 1633093 | Medicaid | AK | |
| 1636141 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Darlene S Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487637948 PECOS PAC ID: 9739377250 Enrollment ID: I20121212000608 |
| Provider Name | Tara E Workman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1306210612 PECOS PAC ID: 4486957602 Enrollment ID: I20160122001466 |
| Provider Name | Tammy L Hill |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1982657144 PECOS PAC ID: 0345509303 Enrollment ID: I20180119000807 |
| Provider Name | Cody S Crockett |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1659754133 PECOS PAC ID: 2860707197 Enrollment ID: I20180718001527 |
| Provider Name | Gina N Phillips |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164940722 PECOS PAC ID: 6800160110 Enrollment ID: I20210630001154 |
| Provider Name | Carly Amelia Kopinski |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1467023838 PECOS PAC ID: 2961896303 Enrollment ID: I20220228002032 |
| Provider Name | Stephanie Roseman Tullar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962100669 PECOS PAC ID: 0244695070 Enrollment ID: I20230501002803 |
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