Provider Demographics
NPI:1790645091
Name:HUYNH, JANICE HA (DPT, PT)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:HA
Last Name:HUYNH
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3765 E BLUE LUPINE DR STE E
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-8417
Mailing Address - Country:US
Mailing Address - Phone:907-332-0021
Mailing Address - Fax:907-373-9464
Practice Address - Street 1:7985 E 16TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-2896
Practice Address - Country:US
Practice Address - Phone:907-332-0021
Practice Address - Fax:907-373-9464
Is Sole Proprietor?:No
Enumeration Date:2025-11-18
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK243061225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist