Provider Demographics
NPI:1871758771
Name:BRICE, CASSANDRA CATHLEEN (PT)
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:CATHLEEN
Last Name:BRICE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2310 PEGER RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-5305
Mailing Address - Country:US
Mailing Address - Phone:907-457-7678
Mailing Address - Fax:907-457-7677
Practice Address - Street 1:2310 PEGER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-5305
Practice Address - Country:US
Practice Address - Phone:907-457-7678
Practice Address - Fax:907-457-7677
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK713225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist