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General NPI Number Information
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NPI Number | 1689020208
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Entity Type | Individual
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Provider Name | ALYSE CELLA ATC
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Gender | Female
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Dates
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Enumeration Date | 05/12/2016
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 2817 ROCK MERRITT AVE
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City | FORT BRAGG
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State | NC
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Zip | 28310-3049
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Country | US
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Telephone | 973-768-3786
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Fax |
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Provider Business Mailing Address
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Address Line | 417 KENDALL DR
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-3701
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | LAT-6005
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License Number State | NC
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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 | AT003193
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0126003472
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | PA
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