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NPI Code Detail

MEDICARE: ALYSSA CORRIN SHORES

MEDICARE: ALYSSA CORRIN SHORES
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
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1497348668
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA CORRIN SHORES
Provider Business Mailing Address
First Line : 219 N SPRING ST
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27101-2768
Country : US
Telephone Number : 336-366-0426
Fax Number :
Provider Business Practice Location Address
First Line : 219 N SPRING ST
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27101-2768
Country : US
Telephone Number : 336-366-0426
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2021
Last Update Date : 02/18/2021

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Directions to “ ALYSSA CORRIN SHORES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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