Provider Demographics
NPI:1184674640
Name:HELLEBUSCH, ALYSSA L (PT)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:L
Last Name:HELLEBUSCH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26634
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66225-6634
Mailing Address - Country:US
Mailing Address - Phone:913-906-8656
Mailing Address - Fax:913-906-8151
Practice Address - Street 1:7600 W 110TH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2323
Practice Address - Country:US
Practice Address - Phone:913-906-8656
Practice Address - Fax:913-906-8151
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2010-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06775R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist