Provider Demographics
NPI:1942574306
Name:REEDY, ALYSSA CRISTINE (LMT)
Entity Type:Individual
Prefix:MISS
First Name:ALYSSA
Middle Name:CRISTINE
Last Name:REEDY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:ALI
Other - Middle Name:CRISTINE
Other - Last Name:REEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:1109 ROLLINS ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-3708
Mailing Address - Country:US
Mailing Address - Phone:406-450-0795
Mailing Address - Fax:
Practice Address - Street 1:1109 ROLLINS ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-3708
Practice Address - Country:US
Practice Address - Phone:406-450-0795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-02
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT815225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist