Healthcare Provider Details

I. General information

NPI: 1285244038
Provider Name (Legal Business Name): ALYSSA OEHLER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2007 MEADE PKWY
SUFFOLK VA
23434-4259
US

IV. Provider business mailing address

2122 YORK RD STE 300
OAK BROOK IL
60523-1925
US

V. Phone/Fax

Practice location:
  • Phone: 757-539-6300
  • Fax:
Mailing address:
  • Phone: 630-575-6200
  • Fax: 410-648-4878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305213793
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: