Healthcare Provider Details

I. General information

NPI: 1477289668
Provider Name (Legal Business Name): ALYSSA RANEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5825 DELMONICO DR STE 100
COLORADO SPRINGS CO
80919-2243
US

IV. Provider business mailing address

209 POTTER LN
YORKTOWN VA
23693-0010
US

V. Phone/Fax

Practice location:
  • Phone: 757-506-1708
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT018231
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT210002165
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP059218T
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305215085
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: