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General NPI Number Information
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NPI Number | 1013367689
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Entity Type | Individual
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Provider Name | ALYSSA CHRISTINE DODD MS, LAT, ATC, OTC
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Gender | Female
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Dates
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Enumeration Date | 06/15/2016
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Last Update Date | 02/16/2023
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Provider Practice Location Address
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Address Line | 15813 PAUL VEGA MD DR STE 100
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City | HAMMOND
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State | LA
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Zip | 70403-1431
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Country | US
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Telephone | 985-230-2663
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Fax |
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Provider Business Mailing Address
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Address Line | 15813 PAUL VEGA MD DR STE 100
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City | HAMMOND
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State | LA
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Zip | 70403-1431
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZX2200X
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Taxonomy Name | Orthopedic Assistant
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License Number | 22-1108
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 312204
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License Number State | LA
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