Provider Demographics
NPI:1194314708
Name:CEDERBERG, ANALISA (ATC)
Entity type:Individual
Prefix:
First Name:ANALISA
Middle Name:
Last Name:CEDERBERG
Suffix:
Gender:
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11353 CONQUISTADOR DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7930
Mailing Address - Country:US
Mailing Address - Phone:907-575-5455
Mailing Address - Fax:
Practice Address - Street 1:11353 CONQUISTADOR DR
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7930
Practice Address - Country:US
Practice Address - Phone:907-575-5455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-18
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer