Healthcare Provider Details

I. General information

NPI: 1033570007
Provider Name (Legal Business Name): ALYSS FILER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2016
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 CONSTITUTION AVE NE
ALBUQUERQUE NM
87110-7513
US

IV. Provider business mailing address

13609 CALIFORNIA ST STE 200
OMAHA NE
68154-5245
US

V. Phone/Fax

Practice location:
  • Phone: 505-296-5565
  • Fax: 402-895-7812
Mailing address:
  • Phone: 585-780-0456
  • Fax: 402-895-7812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number0013799
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA1631
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: