Provider Demographics
NPI:1215581707
Name:KOWALCZK, SARAH REA (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:REA
Last Name:KOWALCZK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:REA
Other - Last Name:MARCHISIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1700 E BOGARD RD STE B203
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-6570
Mailing Address - Country:US
Mailing Address - Phone:907-921-5088
Mailing Address - Fax:907-921-5089
Practice Address - Street 1:1700 E BOGARD RD STE B203
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-6570
Practice Address - Country:US
Practice Address - Phone:907-921-5088
Practice Address - Fax:907-921-5089
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1448292251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK144829Medicaid