Provider Demographics
NPI:1538850656
Name:REALIFE PHYSICAL THERAPY & WELLNESS
Entity type:Organization
Organization Name:REALIFE PHYSICAL THERAPY & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MAGEE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:844-949-9075
Mailing Address - Street 1:7362 W PARKS HWY # 422
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99623-9300
Mailing Address - Country:US
Mailing Address - Phone:844-949-9075
Mailing Address - Fax:
Practice Address - Street 1:4524 S MAINSAIL AVE BLDG 2
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99623-0352
Practice Address - Country:US
Practice Address - Phone:844-949-9075
Practice Address - Fax:844-907-5075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy