Provider Demographics
NPI:1235599259
Name:PELUFFO, ALYSSA (DPT)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:PELUFFO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 E RIVERSIDE DR STE 303
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8722
Mailing Address - Country:US
Mailing Address - Phone:435-673-4303
Mailing Address - Fax:435-673-4003
Practice Address - Street 1:617 E RIVERSIDE DR STE 303
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-8722
Practice Address - Country:US
Practice Address - Phone:435-673-4303
Practice Address - Fax:435-673-4003
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT2911402251X0800X
UT12115579-24012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT12115579-2401OtherLICENSE
CAPT291140OtherLICENSE