Jack L Wade, PT

NPI #1942368857 in Wasilla, Alaska

Provider Information

NPI Number: 1942368857
Entity Type: Individual
Name: Jack L Wade, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Dec 4, 2006
Last Updated: Jul 9, 2007

Practice Location

Address: 3035 PALMER WASILLA HWY STE 401
City: Wasilla
State: Alaska
ZIP Code: 99654-7274
Phone: (907) 376-8590

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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