Provider Demographics
NPI:1306380795
Name:POLLARD-MCGRANDY, ALYSSA
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:POLLARD-MCGRANDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 N 2ND ST
Mailing Address - Street 2:PO BOX 4
Mailing Address - City:FREELAND
Mailing Address - State:MI
Mailing Address - Zip Code:48623-2504
Mailing Address - Country:US
Mailing Address - Phone:989-327-7448
Mailing Address - Fax:
Practice Address - Street 1:7400 BAY RD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY CENTER
Practice Address - State:MI
Practice Address - Zip Code:48710-0001
Practice Address - Country:US
Practice Address - Phone:989-964-2546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI26010015712255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer