Provider Demographics
NPI:1497467344
Name:COLYN, ALYSSA (DPT)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:COLYN
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 1:4028 DALE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-9561
Mailing Address - Country:US
Mailing Address - Phone:209-312-9739
Mailing Address - Fax:
Practice Address - Street 1:3609 OAKDALE RD STE 3
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95357-0718
Practice Address - Country:US
Practice Address - Phone:209-312-9591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist