Basic Information
| Provider Information | |||||||||
| NPI: | 1841715190 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | PATEL | ||||||||
| FirstName: | ALYSSA | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1132 CLEVELAND HALL BLVD | ||||||||
| Address2: | |||||||||
| City: | OLD HICKORY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371382350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6155254335 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5651 FRIST BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | HERMITAGE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370762056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158850200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2017 | ||||||||
| LastUpdateDate: | 08/08/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 6616 | TN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.