Provider Demographics
NPI:1235749573
Name:DRAEGER, ALYSSA (DCM, LAC)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:
Last Name:DRAEGER
Suffix:
Gender:F
Credentials:DCM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 S VIEW DR STE 15231
Mailing Address - Street 2:
Mailing Address - City:MOSINEE
Mailing Address - State:WI
Mailing Address - Zip Code:54455-8203
Mailing Address - Country:US
Mailing Address - Phone:715-814-1244
Mailing Address - Fax:
Practice Address - Street 1:880 S VIEW DR STE 15231
Practice Address - Street 2:
Practice Address - City:MOSINEE
Practice Address - State:WI
Practice Address - Zip Code:54455-8203
Practice Address - Country:US
Practice Address - Phone:715-814-1244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-02
Last Update Date:2020-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1000-55171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty