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NPI Code Detail

MEDICARE: ALYSSA BOBEN DPT

MEDICARE: ALYSSA BOBEN 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
12251X0800XOrthopedic Physical Therapist10796MN

General Provider Information

NPI Number : 1477082840
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA BOBEN DPT
Provider Business Mailing Address
First Line : PO BOX 7197
Second Line :
City : ROCHESTER
State : MN
Zip : 55903-7197
Country : US
Telephone Number : 507-322-3460
Fax Number : 507-322-3450
Provider Business Practice Location Address
First Line : 1309 SALEM RD SW
Second Line :
City : ROCHESTER
State : MN
Zip : 55902-0993
Country : US
Telephone Number : 507-322-3460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2017
Last Update Date : 12/16/2024

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