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General NPI Number Information
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NPI Number | 1154509974
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Entity Type | Individual
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Provider Name | ALISHA MICHALLE MASSEY DPT
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Gender | Female
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Dates
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Enumeration Date | 02/04/2008
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 1261 N STEAMBOAT DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-6079
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Country | US
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Telephone | 479-313-7631
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 CORPORATE DR STE 400
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City | HOOVER
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State | AL
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Zip | 35242-5424
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT1302
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP033007T
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP033006T
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP025118T
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License Number State | AR
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