Provider Demographics
NPI:1902196645
Name:INSPIRE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:INSPIRE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:S
Authorized Official - Last Name:ZOLLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:907-830-1348
Mailing Address - Street 1:1120 HUFFMAN RD STE 24-583
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3516
Mailing Address - Country:US
Mailing Address - Phone:907-770-9111
Mailing Address - Fax:907-770-9110
Practice Address - Street 1:1120 HUFFMAN RD STE 16
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-3561
Practice Address - Country:US
Practice Address - Phone:907-770-9111
Practice Address - Fax:907-770-9110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-14
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1535225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1535OtherSTATE OF ALASKA OCCUPATIONAL LICENSE
AK616541900OtherOFFICE OF WORKERS COMP PROGRAM - FEDERAL WORKERS COMP (OWCP)
AK1573364Medicaid
AK1535OtherSTATE OF ALASKA OCCUPATIONAL LICENSE