Provider Demographics
NPI:1245998632
Name:ROSSIP, ALANA (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:ROSSIP
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 S TAYLOR AVE APT 2N
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2139
Mailing Address - Country:US
Mailing Address - Phone:650-391-5445
Mailing Address - Fax:
Practice Address - Street 1:12326 E 86TH ST N
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-2543
Practice Address - Country:US
Practice Address - Phone:918-272-3750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK117463225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist