Healthcare Provider Details
I. General information
NPI: 1619740297
Provider Name (Legal Business Name): ALYSSA MARIE MCKEE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/06/2023
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
660 GOLDEN RIDGE RD STE 130
GOLDEN CO
80401-9541
US
IV. Provider business mailing address
660 GOLDEN RIDGE RD STE 130
GOLDEN CO
80401-9541
US
V. Phone/Fax
- Phone: 303-275-2190
- Fax: 720-497-6767
- Phone: 303-275-2190
- Fax: 720-497-6767
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2255A2300X |
| Taxonomy | Athletic Trainer |
| License Number | RT007361 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 19975 |
| License Number State | CO |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT030886 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: