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NPI Code Detail

MEDICARE: ALYSSA GEORGE PT

MEDICARE: ALYSSA GEORGE PT
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 Therapist1195580TX
2225100000XPhysical Therapist10934MN

General Provider Information

NPI Number : 1346481819
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA GEORGE PT
Provider Business Mailing Address
First Line : 7581 9TH ST N STE 100
Second Line :
City : OAKDALE
State : MN
Zip : 55128-6635
Country : US
Telephone Number : 651-748-4338
Fax Number :
Provider Business Practice Location Address
First Line : 1939 MINNEHAHA AVE W STE 100
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-1033
Country : US
Telephone Number : 651-348-7428
Fax Number : 651-348-7432
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2009
Last Update Date : 06/21/2021

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Practice Location Address:
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