MEDICARE: DR. ALYSSA LOUANN CLARITY DC

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	111N00000X	Chiropractor	6587	MN

General Provider Information

NPI Number	:	1831654987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALYSSA LOUANN CLARITY DC

Provider Business Mailing Address
First Line	:	1322 3RD ST STE 4
Second Line	:
City	:	INTERNATIONAL FALLS
State	:	MN
Zip	:	56649-2129
Country	:	US
Telephone Number	:	218-324-2219
Fax Number	:

Provider Business Practice Location Address
First Line	:	1322 3RD ST STE 4
Second Line	:
City	:	INTERNATIONAL FALLS
State	:	MN
Zip	:	56649-2129
Country	:	US
Telephone Number	:	218-283-2243
Fax Number	:

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

Provider Enumeration Date	:	02/04/2019
Last Update Date	:	09/21/2020

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