MEDICARE: ALYSSA SHAY PFEIFLE P.T

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	2251P0200X	Pediatric Physical Therapist	1984	SD

General Provider Information

NPI Number	:	1649706607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA SHAY PFEIFLE P.T

Provider Business Mailing Address
First Line	:	PO BOX 393
Second Line	:
City	:	BRANDON
State	:	SD
Zip	:	57005-0393
Country	:	US
Telephone Number	:	605-929-4930
Fax Number	:

Provider Business Practice Location Address
First Line	:	26788 485TH AVE
Second Line	:
City	:	VALLEY SPRINGS
State	:	SD
Zip	:	57068
Country	:	US
Telephone Number	:	605-929-4930
Fax Number	:

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

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	05/11/2017

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