MEDICARE: ALYSSA OKAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	7501011361	MI

General Provider Information

NPI Number	:	1013646553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA OKAR

Provider Business Mailing Address
First Line	:	3202 VALLEY OAKS DR
Second Line	:
City	:	WHITE LAKE
State	:	MI
Zip	:	48383-3446
Country	:	US
Telephone Number	:	248-207-7424
Fax Number	:

Provider Business Practice Location Address
First Line	:	3202 VALLEY OAKS DR
Second Line	:
City	:	WHITE LAKE
State	:	MI
Zip	:	48383-3446
Country	:	US
Telephone Number	:	248-207-7424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2022
Last Update Date	:	06/09/2022

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Directions to “ ALYSSA OKAR ” Practice Location

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