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NPI Code Detail

MEDICARE: ALYSSA BROOKS-WELLS DPT

MEDICARE: ALYSSA BROOKS-WELLS 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
1225100000XPhysical TherapistP19809NC

General Provider Information

NPI Number : 1427656933
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA BROOKS-WELLS DPT
Provider Business Mailing Address
First Line : 5813 MAGELLAN WAY APT 206
Second Line :
City : RALEIGH
State : NC
Zip : 27612-2279
Country : US
Telephone Number : 484-553-7020
Fax Number :
Provider Business Practice Location Address
First Line : 2310 BALE ST STE 100
Second Line :
City : RALEIGH
State : NC
Zip : 27608-1795
Country : US
Telephone Number : 919-364-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2020
Last Update Date : 10/16/2020

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