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General NPI Number Information
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NPI Number | 1851873095
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Entity Type | Individual
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Provider Name | ALYSSA MARIE AMUNDSON PT
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Gender | Female
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Dates
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Enumeration Date | 09/04/2018
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Last Update Date | 11/08/2020
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Provider Practice Location Address
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Address Line | 24 8TH ST NW
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City | ROCHESTER
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State | MN
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Zip | 55901-6817
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Country | US
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Telephone | 507-424-4027
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Fax |
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Provider Business Mailing Address
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Address Line | 3205 NE 8TH ST
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City | ANKENY
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State | IA
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Zip | 50021-9211
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Country | US
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Telephone | 515-577-7983
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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 | 11316
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License Number State | MN
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