MEDICARE: PETER ALFANO 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
1	225100000X	Physical Therapist	3389	NM
2	225100000X	Physical Therapist	7214	AZ
3	225100000X	Physical Therapist	3890	CO
4	225100000X	Physical Therapist	1336	OR

General Provider Information

NPI Number	:	1609071174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER ALFANO PT

Provider Business Mailing Address
First Line	:	3080 BLACKBIRD CIRCLE
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244
Country	:	US
Telephone Number	:	205-999-4323
Fax Number	:

Provider Business Practice Location Address
First Line	:	2846 EBERLEIN AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-4402
Country	:	US
Telephone Number	:	541-850-8909
Fax Number	:

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

Provider Enumeration Date	:	06/15/2007
Last Update Date	:	08/04/2008

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Directions to “ PETER ALFANO PT” Practice Location

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