Healthcare Provider Details
I. General information
NPI: 1750760146
Provider Name (Legal Business Name): ALYSSA JEAN MULZER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/19/2015
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1650 COCHRANE CIR UNIT MEDDAC
FORT CARSON CO
80913-4604
US
IV. Provider business mailing address
1650 COCHRANE CIR UNIT MEDDAC
FORT CARSON CO
80913-4604
US
V. Phone/Fax
- Phone: 729-526-7000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PTL0013035 |
| License Number State | CO |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: