Provider Demographics
NPI:1326410309
Name:HILL, ALYSSE (DPT)
Entity Type:Individual
Prefix:
First Name:ALYSSE
Middle Name:
Last Name:HILL
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 1:601 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HART
Mailing Address - State:MI
Mailing Address - Zip Code:49420-1144
Mailing Address - Country:US
Mailing Address - Phone:231-873-3577
Mailing Address - Fax:231-873-3557
Practice Address - Street 1:23955 FREEWAY PARK DR STE C
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-2817
Practice Address - Country:US
Practice Address - Phone:248-534-4400
Practice Address - Fax:248-479-9861
Is Sole Proprietor?:No
Enumeration Date:2015-10-29
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017284225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F41030OtherBCBSM
MI0N79320Medicare PIN