MEDICARE: ALYSSA MARIE REYNOLDS 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
1	225100000X	Physical Therapist	313069	TX

General Provider Information

NPI Number	:	1710679493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA MARIE REYNOLDS DPT

Provider Business Mailing Address
First Line	:	6801 BELL ST STE 1400
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79109-7028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1616 S KENTUCKY ST STE D130
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79102-2235
Country	:	US
Telephone Number	:	806-699-6787
Fax Number	:

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

Provider Enumeration Date	:	05/22/2023
Last Update Date	:	05/22/2023

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Directions to “ ALYSSA MARIE REYNOLDS DPT” Practice Location

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