Provider Demographics
NPI:1043490923
Name:ALWES, MICHELLE (PT)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:ALWES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:MICHELLE
Other - Middle Name:K
Other - Last Name:KINGSBURY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:78078 COUNTRY CLUB DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BERMUDA DUNES
Mailing Address - State:CA
Mailing Address - Zip Code:92203-8173
Mailing Address - Country:US
Mailing Address - Phone:760-345-9934
Mailing Address - Fax:
Practice Address - Street 1:78078 COUNTRY CLUB DR
Practice Address - Street 2:SUITE 205
Practice Address - City:BERMUDA DUNES
Practice Address - State:CA
Practice Address - Zip Code:92203-8173
Practice Address - Country:US
Practice Address - Phone:760-345-9934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24534225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist