Provider Demographics
NPI:1942291026
Name:SALMON, GEORGE Y V (PT)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:Y
Last Name:SALMON
Suffix:V
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 CROSSMAN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99712-1413
Mailing Address - Country:US
Mailing Address - Phone:907-457-6688
Mailing Address - Fax:907-452-6488
Practice Address - Street 1:828 CROSSMAN RD
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99712-1413
Practice Address - Country:US
Practice Address - Phone:907-457-6688
Practice Address - Fax:907-452-6488
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK734225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKPT7734Medicaid
AKPT7734Medicaid
AKP45682Medicare UPIN