MEDICARE: ALYSSA TOTZKE DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1386429249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA TOTZKE DPT

Provider Business Mailing Address
First Line	:	13 PATRICK WAY
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-2318
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 LUND RD UNIT 104
Second Line	:
City	:	SACO
State	:	ME
Zip	:	04072-1806
Country	:	US
Telephone Number	:	207-494-8029
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2023
Last Update Date	:	08/29/2023

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Directions to “ ALYSSA TOTZKE DPT” Practice Location

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