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NPI Code Detail

MEDICARE: DR. ALYSSA ASHLEY FARR PT, DPT

MEDICARE: DR. ALYSSA ASHLEY FARR PT, DPT
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
1225100000XPhysical Therapist303145CA

General Provider Information

NPI Number : 1326756388
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALYSSA ASHLEY FARR PT, DPT
Provider Business Mailing Address
First Line : 27612 RUISENOR
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92692-2727
Country : US
Telephone Number : 949-338-5897
Fax Number :
Provider Business Practice Location Address
First Line : 22521 AVENIDA EMPRESA STE 116
Second Line :
City : RANCHO SANTA MARGARITA
State : CA
Zip : 92688-2046
Country : US
Telephone Number : 949-338-5897
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2022
Last Update Date : 11/09/2022

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