MEDICARE: ALYSON REYES

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	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1891358420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSON REYES

Provider Business Mailing Address
First Line	:	6119 JACKSON DR
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91942-2730
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10225 AUSTIN DR STE 204
Second Line	:
City	:	SPRING VALLEY
State	:	CA
Zip	:	91978-1522
Country	:	US
Telephone Number	:	619-670-4567
Fax Number	:

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

Provider Enumeration Date	:	04/18/2019
Last Update Date	:	06/11/2019

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Directions to “ ALYSON REYES ” Practice Location

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