Provider Demographics
NPI:1942792627
Name:FEDDE, JOSHUA W (PT, DPT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:W
Last Name:FEDDE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 ABBOTT RD
Mailing Address - Street 2:STE 200
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-3449
Mailing Address - Country:US
Mailing Address - Phone:907-279-4266
Mailing Address - Fax:
Practice Address - Street 1:6909 S 157TH ST STE E
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68136-3052
Practice Address - Country:US
Practice Address - Phone:402-933-5448
Practice Address - Fax:402-933-5449
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3819225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist