Provider Demographics
NPI:1346901980
Name:JUSUFOVIC, TAYLOR KATHERINE (PT, DPT, CLT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:KATHERINE
Last Name:JUSUFOVIC
Suffix:
Gender:F
Credentials:PT, DPT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3074 MOUNTAIN VIEW DR STE 184&187
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3144
Mailing Address - Country:US
Mailing Address - Phone:075-311-8889
Mailing Address - Fax:
Practice Address - Street 1:3074 MOUNTAIN VIEW DR STE 184&187
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3144
Practice Address - Country:US
Practice Address - Phone:907-531-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-05
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK199722225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist